Smith, Charles Jackson

Smith, Charles Jackson is an individual health care provider with primary practice located at 222 N 7Th St , Bismarck ND 58501-4436. He recently has only one registered license in Allopathic & Osteopathic Physicians / Nephrology, which is considered as his primary health care specialty. Smith, Charles Jackson can be contacted via phone (701) 323-6000.

Contact Information

Primary practice address
222 N 7Th St Bismarck ND 58501-4436
Fax: (701) 323-5709
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Nephrology 207RN0300X 9851 North Dakota

Profile Details

NPI number 1124194535
LBN Legal business name Smith, Charles Jackson
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 28th, 2006
Last updated Jul 8th, 2007 - about 18 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 1124194535 NPPES
North Dakota MEDICAID 13238

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