Jackson, Robert Derek

Jackson, Robert Derek is an individual health care provider with primary practice located at 2080 Child St , Jacksonville FL 32214-5005. He recently has only one registered license in Allopathic & Osteopathic Physicians / Anesthesiology, which is considered as his primary health care specialty. Jackson, Robert Derek can be contacted via phone (904) 542-7631.

Contact Information

Primary practice address
2080 Child St Jacksonville FL 32214-5005
Phone: (904) 542-7631
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Anesthesiology 207L00000X D0055688 Maryland

Profile Details

NPI number 1780655399
LBN Legal business name Jackson, Robert Derek
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 31st, 2006
Last updated Jul 8th, 2007 - about 18 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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