Jackson, William J

Jackson, William J is an sole proprietor health care provider with primary practice located at 148 Midland Blvd , Shelbyville KY 40065-9734. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Jackson, William J can be contacted via phone (502) 647-1958.

Contact Information

Primary practice address
148 Midland Blvd Shelbyville KY 40065-9734
Phone: (502) 647-1958
Fax: (502) 647-1940
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 18425 Kentucky

Profile Details

NPI number 1447288709
LBN Legal business name Jackson, William J
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jun 28th, 2006
Last updated Jul 9th, 2007 - about 17 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 1447288709 NPPES
Kentucky MEDICAID 64184252
Kentucky Other 000000273132

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