Dr. Ernest W Jackson
Dental Public Health
111 S Meramec Ave
Clayton
, Missouri 63105-1711
Dr. Ernest W Jackson
Dental Public Health
111 S Meramec Ave
Clayton
, Missouri 63105-1711
(573) 635-5512
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About
Features
Specialties
- Dental Public Health
Languages spoken
- English
Location
First Address
- Dr. Ernest W Jackson
- 3702 W Truman Blvd Ste 100
- Jefferson City, MO
- Zip : 65109-4970
- Fax : (573) 635-5512
- Phone : (573) 635-5315
Second Address
- Dr. Ernest W Jackson
- 111 S Meramec Ave
- Clayton, MO
- Zip : 63105-1711
- Fax : (314) 615-8303
- Phone : (314) 615-8153
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FAQs
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 1223D0001X | Dental Public Health | 014969 | MO |
National Provider Identifier
| NPI | 1124113246 |
|---|---|
| Provider Name | Dr. Ernest W Jackson |
| First Address | Jefferson City, MO 65109-4970 |
| Second Address | Clayton, MO 63105-1711 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 04/10/2006 |
| Last Update Date | 08/07/2007 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 406024208 | (05) | MO |
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.