Jackson, Thomas William

Jackson, Thomas William is an individual health care provider with primary practice located at 4444 Magnolia Avenue , Riverside CA 92501-4136. He recently has only one registered license in Allopathic & Osteopathic Physicians / Orthopaedic Surgery, which is considered as his primary health care specialty. Jackson, Thomas William can be contacted via phone (951) 682-5661.

Contact Information

Primary practice address
4444 Magnolia Avenue Riverside CA 92501-4136
Phone: (951) 682-5661
Fax: (951) 686-3758
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Orthopaedic Surgery 207X00000X G49810 California

Profile Details

NPI number 1326083320
LBN Legal business name Jackson, Thomas William
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 17th, 2006
Last updated Mar 28th, 2012 - about 12 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 1326083320 NPPES
California MEDICAID ZZZZ9647Z9

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