Jackson, Woody H
Jackson, Woody H is an individual health care provider with primary practice located at 2131 S 17Th St , Wilmington NC 28401-7407. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Family Medicine, Allopathic & Osteopathic Physicians / Internal Medicine. Allopathic & Osteopathic Physicians / Family Medicine is his primary health care specialty. Jackson, Woody H can be contacted via phone (910) 815-5830.Contact Information
Primary practice address
2131 S 17Th St
Wilmington NC 28401-7407
Phone: (910) 815-5830
Fax: (910) 815-5698
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | MD063122L | Pennsylvania |
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | MD063122L | Pennsylvania |
Profile Details
| NPI number | 1073587598 |
|---|---|
| LBN Legal business name | Jackson, Woody H |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Feb 13th, 2006 |
| Last updated | Aug 19th, 2014 - about 12 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 | 1073587598 | NPPES |
| North Carolina | MEDICAID | 5919880 | |
| North Carolina | MEDICAID | 001688698 | |
| North Carolina | Other | 232359401 | |
| North Carolina | MEDICAID | Q0029K |
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