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JACKSON FAMILY PRACTICE LLC NPI 1467819920


NPI Information

NPI: 1467819920
Provider Name: JACKSON FAMILY PRACTICE LLC
Classification: Family Medicine - 207Q00000X
Entity Type: Organization

CLIA Number: 36D2109439

Address:
500 BURLINGTON RD
SUITE 260
JACKSON, OH
ZIP 45640
Phone: (740) 577-9181
Get Directions

JACKSON FAMILY PRACTICE LLC is a family medicine in Jackson, OH. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. JACKSON FAMILY PRACTICE LLC NPI is 1467819920. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

500 BURLINGTON RD
SUITE 260
JACKSON, OH
ZIP 45640-360
Phone: (740) 577-9181
Fax: (740) 577-9214

The provider's authorized official is Maryann Hartwick .
The authorized official title is Practice Manager and has the following contact phone number (740) 577-9181.

The CLIA number assigned to this NPI record is 36D2109439 - physician office with a certificate type of Certificate for Provider-Performed Microscopy Procedures (PPMP).

The enumeration date for this NPI number is 1/28/2016 and was last updated on 3/24/2016.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207Q00000XFamily MedicineYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1H422750MEDICARE PIN

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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