Jackson, Terry S
Jackson, Terry S is an individual health care provider with primary practice located at 560 W Mitchell St Suite 300, Petoskey MI 49770-2275. He recently has only one registered license in Allopathic & Osteopathic Physicians / Internal Medicine, which is considered as his primary health care specialty. Jackson, Terry S can be contacted via phone (231) 487-2460.Contact Information
Primary practice address
560 W Mitchell St Suite 300
Petoskey MI 49770-2275
Phone: (231) 487-2460
Fax: (231) 487-6596
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | 5101012250 | Michigan |
Profile Details
| NPI number | 1932106234 |
|---|---|
| LBN Legal business name | Jackson, Terry S |
| Credentials | Doctor of Osteopathy (DO) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 30th, 2005 |
| Last updated | Jul 8th, 2007 - about 17 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 | 1932106234 | NPPES |
| Michigan | MEDICAID | 114085703 |
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