Melissa Lousie Jackson
Sports Medicine Doctor
4 Victory Ln
Scarborough
, Maine 04074-8486
Melissa Lousie Jackson
Sports Medicine Doctor
4 Victory Ln
Scarborough
, Maine 04074-8486
(207) 939-7627
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About
Features
Specialties
- Sports Medicine Doctor
Languages spoken
- English
Location
First Address
- Melissa Lousie Jackson
- 4 Victory Ln
- Scarborough, ME
- Zip : 04074-8486
- Phone : (207) 939-7627
Second Address
- Melissa Lousie Jackson
- 4 Victory Ln
- Scarborough, ME
- Zip : 04074-8486
- Phone : (207) 939-7627
Reviews
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 204C00000X | Sports Medicine Doctor | MT3643 | ME |
National Provider Identifier
| NPI | 1497064695 |
|---|---|
| Provider Name | Melissa Lousie Jackson |
| First Address | Scarborough, ME 04074-8486 |
| Second Address | Scarborough, ME 04074-8486 |
| Gender | F |
| NPI Entity type | Individual |
| Is Sole Proprietor | Yes |
| Is Organization Subpart | N/A |
| Enumeration Date | 05/10/2010 |
| Last Update Date | 05/10/2010 |
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.