Kimberley Evelyn Jackson in Pueblo - General Practice
Kimberley Evelyn Jackson - NPI 1154586832
Kimberley Evelyn Jackson is a General Practice in Pueblo, Colorado. Kimberley Evelyn Jackson practices all healthcare services and medical treatments related to General Practice. The NPI Number for Kimberley Evelyn Jackson is 1154586832. The last update date is 2011-09-16.
Kimberley Evelyn Jackson's current location address is 902 Lakeview Ave, Pueblo, Colorado. You can contact this provider via phone number 7195575855 and fax number 7195574690. The mailing address for Kimberley Evelyn Jackson is 902 Lakeview Ave, Pueblo, Colorado. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Kimberley Evelyn Jackson |
|---|---|
| Address | 902 Lakeview Ave, Pueblo, Colorado |
| Phone Number | 7195575855 |
| Fax Number | 7195574690 |
| Sole Proprietor | N |
| Credentials | D.O. |
NPI Number Detail
| NPI Number | 1154586832 |
|---|---|
| Provider Enumeration Date | 2008-07-22 |
| Last Updated Date | 2011-09-16 |
Provider Mailing Address Detail
| Address | 902 Lakeview Ave |
|---|---|
| City | Pueblo |
| State | Colorado (CO) |
| Post Code | 810043597 |
| Phone Number | 7195575855 |
| Fax Number | 7195574690 |
Provider's Primary Taxonomy Detail
| Speciality | General Practice |
|---|---|
| Taxonomy | 208D00000X |
| Licence No | OS014960 |
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Definition: A physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions. |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| OS014960 | PA | PENNSYLVANIA OSTEOPATHIC MEDIC | |
| 50533 | CO | COLORADO LICENSE |
Post Comment/ Review Below
What is the Kimberley Evelyn Jackson's 1154586832?
The Kimberley Evelyn Jackson's NPI (National Provider Identifier) Number is 1154586832. This unique 10-digit identification number is assigned to health care providers by the Centers for Medicare & Medicaid Services (CMS).
Could you kindly provide the complete physical address where Kimberley Evelyn Jackson's facilities are geographically located?
The facilities of Kimberley Evelyn Jackson are physically situated at the following location: 902 Lakeview Ave, Pueblo, CO, 810043597.
What is Kimberley Evelyn Jackson's primary field of medical specialization, and what is the corresponding taxonomy classification code for this area of expertise?
The primary field of medical specialization for Kimberley Evelyn Jackson is General Practice, and the taxonomy classification code that categorizes this area of expertise is 208D00000X.
On what date did the Centers for Medicare & Medicaid Services issue the 1154586832 to Kimberley Evelyn Jackson?
The Kimberley Evelyn Jackson received its 1154586832 assignment from the Centers for Medicare & Medicaid Services on 2008-07-22.
As of what date was the information pertaining to Kimberley Evelyn Jackson, such as address, specialty, and other details, last reviewed and confirmed to be accurate?
The information related to Kimberley Evelyn Jackson, including its address, specialty, and other relevant details, was last reviewed and confirmed to be accurate on 2011-09-16.