Tackett, Jim R

Tackett, Jim R is an individual health care provider with primary practice located at 1101 Veterans Dr , Lexington KY 40502-2235. 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. Tackett, Jim R can be contacted via phone (859) 233-4511.

Contact Information

Primary practice address
1101 Veterans Dr Lexington KY 40502-2235
Phone: (859) 233-4511
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X PA553 Kentucky

Profile Details

NPI number 1104882083
LBN Legal business name Tackett, Jim R
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 21st, 2006
Last updated Feb 24th, 2011 - about 13 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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