Jessica S Jackson Dpm Pllc

LBN: Jessica S Jackson Dpm Pllc
Jessica S Jackson Dpm Pllc is an health care organization with primary practice located at 15014 Bircham Rd , Louisville KY 40245-4104. The organization recently has only one registered license in Podiatric Medicine & Surgery Service Providers / Podiatrist, which is considered as the primary health care specialty. Jessica S Jackson Dpm Pllc can be contacted via phone (502) 558-0194, or through Jackson, Jessica via phone (502) 558-0194.

Contact Information

Primary practice address
15014 Bircham Rd Louisville KY 40245-4104
Phone: (502) 558-0194
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Jackson, Jessica Doctor of Podiatric Medicine (DPM)
Phone: (502) 558-0194

Health care specialties

SpecialtyCodeLicense #State
Podiatric Medicine & Surgery Service Providers / Podiatrist 213E00000X 00242 Kentucky

Profile Details

NPI number 1558516054
LBN Legal business name Jessica S Jackson Dpm Pllc
DBA Doing business as
Authorized official Jackson, Jessica Doctor of Podiatric Medicine (DPM)
Entity Organization
Organization subpart 1 No
Enumeration date Nov 25th, 2008
Last updated Jan 20th, 2021 - about 4 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1558516054 NPPES
Kentucky MEDICAID 7100071060
Kentucky MEDICAID 201083640A
Kentucky Other DO6474

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