Nguyen, Jackie K

Nguyen, Jackie K is an individual health care provider with primary practice located at 53 Sewall Street , Portland ME 04102. She recently has only one registered license in Allopathic & Osteopathic Physicians / Ophthalmology, which is considered as her primary health care specialty. Nguyen, Jackie K can be contacted via phone (207) 828-2020.

Contact Information

Primary practice address
53 Sewall Street Portland ME 04102
Fax: (207) 773-7034
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Ophthalmology 207W00000X 017896 Maine

Profile Details

NPI number 1326094533
LBN Legal business name Nguyen, Jackie K
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date May 26th, 2006
Last updated Dec 17th, 2021 - about 3 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 1326094533 NPPES
Maine MEDICAID 433089999

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