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Contact Information

DARRELL JACKSON
2405 MULLINS AVE
ALAMOSA, CO81101
 Phone: 719-589-5272
 Fax: 719-589-5300
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

General Practice

1223G0001X
Indicates primary specialty

NPI Profile & details for DARRELL JACKSON · (Female)

NPI # 1588657795
Status Active
Credentials
Entity Individual
Enumeration date 08/24/2005
Last updated 08/19/2008 - About 18 years ago
Sole proprietor 1 Not specified
Identifiers
  • CO License # 8293
  • CO Medicaid 08230064
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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