Jackson, Robert Wayne

Jackson, Robert Wayne is an individual health care provider with primary practice located at Sigler Ave , Memphis MO 63555. He recently has only one registered license in Allopathic & Osteopathic Physicians / Rheumatology, which is considered as his primary health care specialty. Jackson, Robert Wayne can be contacted via phone (660) 465-2828.

Contact Information

Primary practice address
Sigler Ave Memphis MO 63555
Phone: (660) 465-2828
Fax: (660) 465-2820
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Rheumatology 207RR0500X R6C73 Missouri

Profile Details

NPI number 1730293705
LBN Legal business name Jackson, Robert Wayne
Credentials Doctor of Osteopathy (DO)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 18th, 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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Identifiers

StateTypeNumberIssuer
All States NPI 1730293705 NPPES
Missouri MEDICAID 241853779

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