Dr. Amie Elissa Jackson
Internist Hematology & Oncology
5520 Cheviot Rd
Cincinnati
, Ohio 45247-7069
Dr. Amie Elissa Jackson
Internist Hematology & Oncology
5520 Cheviot Rd
Cincinnati
, Ohio 45247-7069
(513) 853-4721
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About
Features
Specialties
- Internist
- Hematology & Oncology
Languages spoken
- English
Location
First Address
- Dr. Amie Elissa Jackson
- 4685 Forest Ave Ste C
- Cincinnati, OH
- Zip : 45212-3397
- Phone : (513) 853-4721
Second Address
- Dr. Amie Elissa Jackson
- 5520 Cheviot Rd
- Cincinnati, OH
- Zip : 45247-7069
- Phone : (513) 451-4033
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| N | 207R00000X | Internist | 2009014806 | MO |
| N | 111NI0900X | Internist | 2009014806 | MO |
| N | 207RH0003X | Hematology & Oncology | 106237 | MN |
| Y | 207RH0003X | Hematology & Oncology | 35.123128 | OH |
| N | 207RH0003X | Hematology & Oncology | 55653 | MN |
National Provider Identifier
| NPI | 1023246949 |
|---|---|
| Provider Name | Dr. Amie Elissa Jackson |
| First Address | Cincinnati, OH 45212-3397 |
| Second Address | Cincinnati, OH 45247-7069 |
| Gender | F |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 30/06/2009 |
| Last Update Date | 21/08/2015 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| ENROLLED | (05) | IA |
| ENROLLED | (05) | MN |
| ENROLLED | (05) | SD |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.