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Contact Information

HORACE J JACKSON MD PC
464 MAIN STREET
WARSAW, VA22572
 Phone: 804-788-0556
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Gastroenterology

207RG0100X 10 Physician/Gastroenterology
Indicates primary specialty

NPI Profile & details for HORACE J JACKSON MD PC

NPI Number 1144466368
LBN Legal business name HORACE J JACKSON MD PC
Authorized official HORACE JACKSON - (PRESIDENT OWNER)
Entity Organization
Organization subpart 1 No
Enumeration date 12/17/2008
Last updated 12/17/2008 - About 17 years ago
Identifiers
VA Medicaid 006O49656
VA Other 006954 ANTHEM
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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