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Contact Information

DERRICK JACKSON, MHPP
177 BUSH STREET
BUILDING 77
HUGHES, AR72348
 Phone: 870-339-3701
 Fax: 870-339-3941
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Case Manager/Care Coordinator

171M00000X
Indicates primary specialty

NPI Profile & details for DERRICK JACKSON · (Male)

NPI Number 1225463847
Status Active
Credentials MHPP
Entity Individual
Enumeration date 09/13/2013
Last updated 09/13/2013 - About 13 years ago
Sole proprietor 1 No
Identifiers Not Available
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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