Jackson, Rubie Sue
Jackson, Rubie Sue is an sole proprietor health care provider with primary practice located at 2000 Medical Parkway Suite 200, Annapolis MD 21401. She recently has 2 registered licenses in different health care specialties including Student, Health Care / Student in an Organized Health Care Education/Training Program, Allopathic & Osteopathic Physicians / Surgery. Allopathic & Osteopathic Physicians / Surgery is her primary health care specialty. Jackson, Rubie Sue can be contacted via phone (443) 481-5300.Contact Information
Primary practice address
2000 Medical Parkway Suite 200
Annapolis MD 21401
Phone: (443) 481-5300
Fax: (443) 481-6705
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Student, Health Care / Student in an Organized Health Care Education/Training Program | 390200000X | ||
| Allopathic & Osteopathic Physicians / Surgery | 208600000X | D77385 | Maryland |
Profile Details
| NPI number | 1528209293 |
|---|---|
| LBN Legal business name | Jackson, Rubie Sue |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Mar 10th, 2009 |
| Last updated | Feb 5th, 2015 - about 10 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1528209293 | NPPES |
| Maryland | MEDICAID | 213518300 |
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