Teasdall, Kathy Jackson

Teasdall, Kathy Jackson is an individual health care provider with primary practice located at 755 Highland Oaks Dr Ste 204, Winston Salem NC 27103-7106. She recently has only one registered license in Allopathic & Osteopathic Physicians / Otolaryngology, which is considered as her primary health care specialty. Teasdall, Kathy Jackson can be contacted via phone (336) 768-1037.

Contact Information

Primary practice address

755 Highland Oaks Dr Ste 204 Winston Salem NC 27103-7106

Phone: (336) 768-1037

Fax: (336) 768-9141

Website:

Map and Directions

Health care specialties

Specialty	Code	License #	State
Allopathic & Osteopathic Physicians / Otolaryngology	207Y00000X	9400157	North Carolina

Profile Details

NPI number	1962448704
LBN Legal business name	Teasdall, Kathy Jackson
Credentials	Doctor of Medicine (MD)
Entity	Individual
Sole proprietor ¹	No
Enumeration date	Jun 21st, 2006
Last updated	Jun 20th, 2013 - about 12 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

State	Type	Number	Issuer
All States	NPI	1962448704	NPPES
North Carolina	MEDICAID	8982338

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