Smith, Marion Jackson
Smith, Marion Jackson is an sole proprietor health care provider with primary practice located at 3100 Schofield Rd Bldg 1179 , Jbsa Fsh TX 78234-7577. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as his primary health care specialty. Smith, Marion Jackson can be contacted via phone (910) 286-0222.Contact Information
Primary practice address
3100 Schofield Rd Bldg 1179
Jbsa Fsh TX 78234-7577
Phone: (910) 286-0222
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant | 363A00000X | 1073896 |
Profile Details
| NPI number | 1780729483 |
|---|---|
| LBN Legal business name | Smith, Marion Jackson |
| Credentials | Physician's Assistant Certified (PA-C) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Feb 20th, 2007 |
| Last updated | Dec 9th, 2016 - about 8 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 | 1780729483 | NPPES |
| Other | 1073896 | NCCPA CERTIFICATE # |
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