Jackson, Stephanie J.
Jackson, Stephanie J. is an individual health care provider with primary practice located at 705 Riley Hospital Dr Roc 4270, Indianapolis IN 46202-5109. She recently has 3 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Pediatrics, Allopathic & Osteopathic Physicians / Neurology with Special Qualifications in Child Neurology, Allopathic & Osteopathic Physicians / Sleep Medicine. Allopathic & Osteopathic Physicians / Sleep Medicine is her primary health care specialty. Jackson, Stephanie J. can be contacted via phone (317) 274-7208.Contact Information
Primary practice address
705 Riley Hospital Dr Roc 4270
Indianapolis IN 46202-5109
Phone: (317) 274-7208
Fax: (317) 274-7227
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Allopathic & Osteopathic Physicians / Pediatrics | 208000000X | 125053014 | Illinois |
Allopathic & Osteopathic Physicians / Neurology with Special Qualifications in Child Neurology | 2084N0402X | 01071127 | Indiana |
Allopathic & Osteopathic Physicians / Sleep Medicine | 2080S0012X | 01071127A | Indiana |
Profile Details
NPI number | 1033375043 |
---|---|
LBN Legal business name | Jackson, Stephanie J. |
Credentials | Doctor of Medicine (MD) |
Entity | Individual |
Sole proprietor 1 | No |
Enumeration date | Jul 30th, 2008 |
Last updated | Jan 12th, 2021 - about 3 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 | 1033375043 | NPPES |
Indiana | MEDICAID | 201107390 |
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