Young, Lisa Jackson

Young, Lisa Jackson is an individual health care provider with primary practice located at 7460 Wolf River Boulevard , Germantown TN 38138. She recently has only one registered license in Allopathic & Osteopathic Physicians / Cardiovascular Disease, which is considered as her primary health care specialty. Young, Lisa Jackson can be contacted via phone (901) 763-0200.

Contact Information

Primary practice address
7460 Wolf River Boulevard Germantown TN 38138
Phone: (901) 763-0200
Fax: (901) 260-1713
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Cardiovascular Disease 207RC0000X 38424 Tennessee

Profile Details

NPI number 1073513008
LBN Legal business name Young, Lisa Jackson
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 1st, 2005
Last updated May 23rd, 2024 - about 6 months 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 1073513008 NPPES
Tennessee Other P00882938 RAILROAD MEDICARE
Tennessee MEDICAID 3891911 RAILROAD MEDICARE
Tennessee MEDICAID 154284001 RAILROAD MEDICARE
Tennessee Other 4270159 RAILROAD MEDICARE
Tennessee MEDICAID 01575895 RAILROAD MEDICARE

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