Salah, Jack Jerry

Salah, Jack Jerry is an individual health care provider with primary practice located at 3599 University Blvd S Suite 901, Jacksonville FL 32216-4252. He recently has only one registered license in Allopathic & Osteopathic Physicians / Pulmonary Disease, which is considered as his primary health care specialty. Salah, Jack Jerry can be contacted via phone (904) 398-6971.

Contact Information

Primary practice address
3599 University Blvd S Suite 901 Jacksonville FL 32216-4252
Phone: (904) 398-6971
Fax: (904) 398-2497
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pulmonary Disease 207RP1001X ME0041346 Florida

Profile Details

NPI number 1336140938
LBN Legal business name Salah, Jack Jerry
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 3rd, 2005
Last updated Jan 25th, 2010 - 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1336140938 NPPES
Florida MEDICAID 045079100

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