National Provider Identifier Database

JAMES JACKSON MD LLC
Rehabilitation


Contact Information

JAMES JACKSON, MD LLC
3330 NW 56TH ST STE 612
OKLAHOMA CITY, OK73112-4470
Phone: 405-610-8810
Fax:
Website:
Specialty Taxonomy Code
* Rehabilitation 261QR0400X

* Indicates primary specialty

NPI Profile & details for JAMES JACKSON, MD LLC

NPI Number 1558858068
Legal business name
LBN
JAMES JACKSON, MD LLC
Authorized official TAWANA HILL - (CREDENTIALING SPECIALIST)
Entity Organization
Organization subpart No
Enumeration date 04/19/2018
Last updated 04/19/2018 - About 8 years ago
Sole proprietor1 Not specified
Identifiers
  • OK License #: 27258
  • OK Medicaid: 2019800000X
  • OK Medicaid: 202K00000X

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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