Jackson, William Thomas

Jackson, William Thomas is an individual health care provider with primary practice located at 131 Medical Park Road Suite 204, Mooresville NC 28117-8524. He recently has only one registered license in Allopathic & Osteopathic Physicians / Orthopaedic Surgery, which is considered as his primary health care specialty. Jackson, William Thomas can be contacted via phone (704) 664-5633.

Contact Information

Primary practice address
131 Medical Park Road Suite 204 Mooresville NC 28117-8524
Phone: (704) 664-5633
Fax: (704) 664-5631
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Orthopaedic Surgery 207X00000X 2002-01368 North Carolina

Profile Details

NPI number 1700868106
LBN Legal business name Jackson, William Thomas
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 19th, 2005
Last updated Jul 30th, 2008 - about 16 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 1700868106 NPPES
North Carolina MEDICAID 891321P

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