Jackson, Tanjela M

Jackson, Tanjela M is an individual health care provider with primary practice located at 3620 M L King Jr Dr Sw , Atlanta GA 30331-3711. She recently has only one registered license in Allopathic & Osteopathic Physicians / Nephrology, which is considered as her primary health care specialty. Jackson, Tanjela M can be contacted via phone (404) 696-7300.

Contact Information

Primary practice address
3620 M L King Jr Dr Sw Atlanta GA 30331-3711
Phone: (404) 696-7300
Fax: (404) 699-3514
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Nephrology 207RN0300X 054755 Georgia

Profile Details

NPI number 1265420574
LBN Legal business name Jackson, Tanjela M
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 11th, 2005
Last updated Dec 16th, 2020 - about 5 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 1265420574 NPPES
Georgia Other 2490487 UNITED HEALTH CARE
Georgia MEDICAID 748360477F UNITED HEALTH CARE
Georgia MEDICAID 748360477H UNITED HEALTH CARE
Georgia MEDICAID 748360477 UNITED HEALTH CARE
Georgia Other 7889745 UNITED HEALTH CARE
Georgia Other 52152577 UNITED HEALTH CARE
Georgia Other 7368440 UNITED HEALTH CARE
Georgia MEDICAID 748360477G UNITED HEALTH CARE
Georgia MEDICAID 748360477K UNITED HEALTH CARE
Georgia MEDICAID 748360477E UNITED HEALTH CARE
Georgia MEDICAID 748360477I UNITED HEALTH CARE
Georgia MEDICAID 748360477J UNITED HEALTH CARE

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