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Contact Information

BILLY M JACKSON, MD
3917 WEST RD
SUITE 150
LOS ALAMOS, NM87544
 Phone: 505-662-4351
 Fax: 505-662-4351
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Surgery

208600000X 02 Physician/General Surgery
Indicates primary specialty

NPI Profile & details for BILLY M JACKSON · (Male)

NPI Number 1629076864
Status Active
Credentials MD
Entity Individual
Enumeration date 07/12/2005
Last updated 04/16/2008 - About 18 years ago
Sole proprietor 1 No
Identifiers
  • NM License # 72160
  • NM Medicaid 18523
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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