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Contact Information

JAMES W JACKSON, MD
630 BROADWAY ST
MADISON, IN47250-3310
 Phone: 812-265-0820
 Fax: 812-265-0570
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Cardiovascular Disease

207RC0000X 11 Physician/Internal Medicine
Indicates primary specialty

NPI Profile & details for JAMES W JACKSON · (Male)

NPI # 1831127208
Status Active
Credentials MD
Entity Individual
Enumeration date 06/28/2006
Last updated 04/22/2008 - About 18 years ago
Sole proprietor 1 No
Identifiers
  • IN License # 01021515
  • IN Medicaid 200149120A
  • KY Medicaid 64337330
  • Other 5412546 AETNA
  • Other 060055388 MEDICARE RAILROAD
  • IN Other 000000210998 ANTHEM BCBS
  • KY Other 2436127000 PASSPORT ADVANTAGE
  • KY Other 1096355 PASSPORT KY MEDICAID
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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