Ms. Dianne Regina Jackson
General Practice Physician
9601 Reistertown Rd
Owings Mills
, Maryland 21117
Ms. Dianne Regina Jackson
General Practice Physician
9601 Reistertown Rd
Owings Mills
, Maryland 21117
(301) 352-9763
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About
Features
Specialties
- General Practice Physician
Languages spoken
- English
Location
First Address
- Ms. Dianne Regina Jackson
- P.o. Box (561)
- Lanham, MD
- Zip : 20703
- Phone : (301) 352-9763
Second Address
- Ms. Dianne Regina Jackson
- 9601 Reistertown Rd
- Owings Mills, MD
- Zip : 21117
- Phone : (301) 352-9763
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Is Ms. Dianne Regina Jackson a sole practitioner?
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 208D00000X | General Practice Physician | D0039496 | MD |
National Provider Identifier
| NPI | 1003193947 |
|---|---|
| Provider Name | Ms. Dianne Regina Jackson |
| First Address | Lanham, MD 20703 |
| Second Address | Owings Mills, MD 21117 |
| Gender | F |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 07/11/2011 |
| Last Update Date | 07/11/2011 |
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.