Westfall, Jackie W

Westfall, Jackie W is an individual health care provider with primary practice located at 2370 E International Speedway Blvd , Deland FL 32724-2744. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Emergency Medicine, Allopathic & Osteopathic Physicians / Family Medicine. Allopathic & Osteopathic Physicians / Family Medicine is his primary health care specialty. Westfall, Jackie W can be contacted via phone (386) 736-1105.

Contact Information

Primary practice address
2370 E International Speedway Blvd Deland FL 32724-2744
Phone: (386) 736-1105
Fax: (386) 734-1443
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Emergency Medicine 207P00000X OS5855 Florida
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X OS5855 Florida

Profile Details

NPI number 1740248152
LBN Legal business name Westfall, Jackie W
Credentials Doctor of Osteopathy (DO)
Entity Individual
Sole proprietor 1 No
Enumeration date May 3rd, 2006
Last updated Oct 11th, 2014 - about 10 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 1740248152 NPPES
Florida Other 80464 BCBS PROVIDER NUMBER
Florida MEDICAID 054261000 BCBS PROVIDER NUMBER

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