Dr. Benjamin Popp Jackson
Family Doctor - Addiction Medicine
34 N Kanawha St
Buckhannon
, West Virginia 26201-2714
Dr. Benjamin Popp Jackson
Family Doctor - Addiction Medicine
34 N Kanawha St
Buckhannon
, West Virginia 26201-2714
(304) 472-1208
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About
Features
Specialties
- Family Doctor - Addiction Medicine
Languages spoken
- English
Location
First Address
- Dr. Benjamin Popp Jackson
- 34 N Kanawha St
- Buckhannon, WV
- Zip : 26201-2714
- Fax : (304) 472-1208
- Phone : (304) 473-2250
Second Address
- Dr. Benjamin Popp Jackson
- 34 N Kanawha St
- Buckhannon, WV
- Zip : 26201-2714
- Fax : (304) 472-1208
- Phone : (304) 473-2250
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 207QA0401X | Family Doctor - Addiction Medicine | 30171 | WV |
National Provider Identifier
| NPI | 1629502562 |
|---|---|
| Provider Name | Dr. Benjamin Popp Jackson |
| First Address | Buckhannon, WV 26201-2714 |
| Second Address | Buckhannon, WV 26201-2714 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 18/04/2017 |
| Last Update Date | 09/09/2021 |
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.