Jackson, Timothy L
Jackson, Timothy L is an individual health care provider with primary practice located at 500 Sharon Rd , Beaver PA 15009-1957. He recently has only one registered license in Allopathic & Osteopathic Physicians / Internal Medicine, which is considered as his primary health care specialty. Jackson, Timothy L can be contacted via phone (724) 728-8751.Contact Information
Primary practice address
500 Sharon Rd
Beaver PA 15009-1957
Phone: (724) 728-8751
Fax: (724) 728-4633
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | MD044713L | Pennsylvania |
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | 35-063422 | Ohio |
Profile Details
| NPI number | 1427070747 |
|---|---|
| LBN Legal business name | Jackson, Timothy L |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 24th, 2006 |
| Last updated | Sep 16th, 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 | 1427070747 | NPPES |
| Pennsylvania | MEDICAID | 0012616830002 |
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