Jackson, William A.
Jackson, William A. is an individual health care provider with primary practice located at 945 82Nd Pkwy Ste 3B, Myrtle Beach SC 29572-4612. He recently has only one registered license in Allopathic & Osteopathic Physicians / Cardiovascular Disease, which is considered as his primary health care specialty. Jackson, William A. can be contacted via phone (843) 839-1201.Contact Information
Primary practice address
945 82Nd Pkwy Ste 3B
Myrtle Beach SC 29572-4612
Phone: (843) 839-1201
Fax: (843) 839-1202
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Cardiovascular Disease | 207RC0000X | 21136 | South Carolina |
Profile Details
| NPI number | 1760471130 |
|---|---|
| LBN Legal business name | Jackson, William A. |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Oct 19th, 2005 |
| Last updated | Jan 20th, 2017 - about 7 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 | 1760471130 | NPPES |
| South Carolina | MEDICAID | 211363 |
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