Doctor Name: | ERIC JACKSON |
NPI Number: | 1821496340 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | |
License Number: | AS4975 |
Business Practice Address: | 1740 Tree Blvd Suite 114 St Augustine, FL - 320845720 |
Business Phone Number: | 9047702333 |
Business Fax Number: | |
Mailing Address: | 1740 Tree Blvd, Suite 114 ST AUGUSTINE |
State: | FL |
Postal Code: | 320845720 |
Phone Number: | 9047702333 |
Fax Number: | |
NPI Enumeration Date: | 12/16/2014 |
NPI Last Update Date: | 12/16/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 237700000X |
License Number: | AS4975 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | FL |
Taxonomy Type: | Speech, Language and Hearing Service Providers |
Taxonomy Classification: | Hearing Instrument Specialist |
Taxonomy Specialization: | |
Taxonomy Definition: | Individuals who test hearing for the selection, adaptation, fitting, adjusting, servicing, and sale of hearing aids. Hearing Instrument Specialist is a designation provided individuals who qualify by the National Hearing Aid Society |