Randolph Jackson, Pamela Dawn
Randolph Jackson, Pamela Dawn is an individual health care provider with primary practice located at 110 Irving St Nw , Washington DC 20010. She recently has only one registered license in Allopathic & Osteopathic Physicians / Radiation Oncology, which is considered as her primary health care specialty. Randolph Jackson, Pamela Dawn can be contacted via phone (800) 353-0788.Contact Information
Primary practice address
110 Irving St Nw
Washington DC 20010
Phone: (800) 353-0788
Fax: (804) 355-6031
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Radiation Oncology | 2085R0001X | DC 19357 | District of Columbia |
Profile Details
| NPI number | 1801813407 |
|---|---|
| LBN Legal business name | Randolph Jackson, Pamela Dawn |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 17th, 2006 |
| Last updated | Dec 23rd, 2011 - about 14 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 | 1801813407 | NPPES |
| Virginia | MEDICAID | 010150469 |
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