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Contact Information

RICHARD E JACKSON, MD
106 PINNACLE DR
SUITE 107
JOHNSON CITY, TN37615-6602
 Phone: 423-328-7332
 Fax: 423-207-1222
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Psychiatry

2084P0800X 26 Physician/Psychiatry
 

Addiction Medicine

2084A0401X 79 Physician/Addiction Medicine
Indicates primary specialty

NPI Profile & details for RICHARD E JACKSON · (Male)

NPI # 1457359770
Status Active
Credentials MD
Entity Individual
Enumeration date 07/11/2005
Last updated 07/17/2014 - About 12 years ago
Sole proprietor 1 Yes
Identifiers
  • TN License # 15545
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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