Your Personal Physician

LBN: Michael S. Jackson, Md, Pc
Your Personal Physician is an health care organization with primary practice located at 701 E 2Nd Ave Sw Suite C, Rome GA 30161-6148. The organization recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as the primary health care specialty. Michael S. Jackson, Md, Pc can be contacted via phone (706) 266-9090, or through Jackson, Michael S via phone (706) 266-9090.

Contact Information

Primary practice address
701 E 2Nd Ave Sw Suite C Rome GA 30161-6148
Phone: (706) 266-9090
Fax: (706) 204-8797
Website:
Map and Directions
Authorized official contact:
Name: Jackson, Michael S Doctor of Medicine (MD)
Phone: (706) 266-9090

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 055376 Georgia

Profile Details

NPI number 1164745782
LBN Legal business name Michael S. Jackson, Md, Pc
DBA Doing business as Your Personal Physician
Authorized official Jackson, Michael S Doctor of Medicine (MD)
Entity Organization
Organization subpart 1 No
Enumeration date Mar 10th, 2010
Last updated Jan 20th, 2011 - about 13 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 1164745782 NPPES
Georgia Other 08BBRKT MEDICARE PTAN
Georgia Other 1306830062 MEDICARE PTAN

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