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Contact Information

BRADLEY C JACKSON
10178 HWY 21
IRONTON, MO63650
 Phone: 573-330-2100
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Transportation Network Company

342000000X
Indicates primary specialty

NPI Profile & details for BRADLEY C JACKSON · (Male)

NPI Number 1144005745
Status Active
Credentials
Entity Individual
Enumeration date 08/30/2023
Last updated 08/30/2023 - About 3 years ago
Sole proprietor 1 Yes
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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