Jackson, Undra

Jackson, Undra is an individual health care provider with primary practice located at 1701 White St , Mccomb MS 39648-2711. He recently has only one registered license in Behavioral Health & Social Service Providers / School, which is considered as his primary health care specialty. Jackson, Undra can be contacted via phone (601) 249-4218.

Contact Information

Primary practice address
1701 White St Mccomb MS 39648-2711
Phone: (601) 249-4218
Fax: (601) 249-4234
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / School 101YS0200X

Profile Details

NPI number 1083196851
LBN Legal business name Jackson, Undra
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 29th, 2018
Last updated Aug 29th, 2018 - about 6 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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