Sweeney, Jackie S

Sweeney, Jackie S is an individual health care provider with primary practice located at 1 Medical Village Dr , Edgewood KY 41017-3403. She recently has only one registered license in Allopathic & Osteopathic Physicians / Diagnostic Radiology, which is considered as her primary health care specialty. Sweeney, Jackie S can be contacted via phone (859) 301-2160.

Contact Information

Primary practice address
1 Medical Village Dr Edgewood KY 41017-3403
Phone: (859) 301-2160
Fax: (859) 301-3932
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Diagnostic Radiology 2085R0202X 24742 Kentucky

Profile Details

NPI number 1487636585
LBN Legal business name Sweeney, Jackie S
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 16th, 2005
Last updated Aug 8th, 2013 - about 11 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 1487636585 NPPES
Ohio MEDICAID 0840924
Ohio Other 300048812
Ohio MEDICAID 64247422

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