Jackson, Robert E

Jackson, Robert E is an individual health care provider with primary practice located at 517 Chesnee Hwy Ste A , Gaffney SC 29341-2709. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Jackson, Robert E can be contacted via phone (864) 487-7655.

Contact Information

Primary practice address
517 Chesnee Hwy Ste A Gaffney SC 29341-2709
Phone: (864) 487-7655
Fax: (864) 487-7818
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 10879 South Carolina

Profile Details

NPI number 1710965637
LBN Legal business name Jackson, Robert E
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 3rd, 2006
Last updated Jan 21st, 2021 - about 4 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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Identifiers

StateTypeNumberIssuer
All States NPI 1710965637 NPPES
South Carolina Other SCG5856067 MEDICARE PIN
South Carolina MEDICAID 018797 MEDICARE PIN
South Carolina Other SCG5856084 MEDICARE PIN
South Carolina Other SCG585J577 MEDICARE PIN
South Carolina Other 080075169 MEDICARE PIN

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