Jackson, William G
Jackson, William G is an sole proprietor health care provider with primary practice located at 202 Alcorn Dr , Corinth MS 38834-9701. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Jackson, William G can be contacted via phone (662) 287-4481.Contact Information
Primary practice address
202 Alcorn Dr
Corinth MS 38834-9701
Phone: (662) 287-4481
Fax: (662) 287-4368
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | 7322 | Mississippi |
Profile Details
| NPI number | 1407852072 |
|---|---|
| LBN Legal business name | Jackson, William G |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jun 28th, 2005 |
| Last updated | Jul 12th, 2013 - about 11 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 | 1407852072 | NPPES |
| Mississippi | MEDICAID | 00016794 |
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