F. DANIEL JACKSON, MD, PA D/B/A LABWORK LLC , NPI 1639187289 — CUMBERLAND (MD)

NPI 1639187289

14+ Years Experience Organization

F. DANIEL JACKSON, MD, PA D/B/A LABWORK LLC

08.03.2006
PROVIDER ENUMERATION DATE
07.08.2007
LAST UPDATE DATE
1639187289
NPI NUMBER

About F. DANIEL JACKSON, MD, PA D/B/A LABWORK LLC

F. DANIEL JACKSON, MD, PA D/B/A LABWORK LLC is a provider established in CUMBERLAND, MD. The NPI number of F. DANIEL JACKSON, MD, PA D/B/A LABWORK LLC is 1639187289 and was assigned on 08.03.2006. The practitioners primary taxonomy code is: 291U00000X with license number: 939 MD .

Mailing address

  • City: CUMBERLAND
  • State: MD
  • Postal code: 215011701
  • Phone: 3017593817
  • Fax: 3017593286
  • Address: PO BOX 1701

Primary Practice Address

  • Region : CUMBERLAND, MD
  • NPI : 1639187289
  • Phone : 3017227270
  • Fax : 3017227274
  • Postalcode : 215024236
  • Address : 130 PENNSYLVANIA AVE

Provider taxonomy - Clinical Medical Laboratory

  • Taxonomy code: 291U00000X
  • License number: 939
  • License state: MD

The taxonomy is the primary taxonomy (there can be only one per NPI record).

Taxonomy description: (1) A clinical laboratory is a facility for the biological, microbiological, serological, chemical, immunohematological, hematological, biophysical, cytological, pathological, or other examination of materials derived from the human body for the purpose of providing information for the diagnosis, prevention, or treatment of any disease or impairment of, human beings. These examinations also include procedures to determine, measure, or otherwise describe the presence or absence of various substances or organisms in the body. Facilities only collecting or preparing specimens (or both) or only serving as a mailing service and not performing testing are not considered clinical laboratories. (2) Any facility that examines materials from the human body for purposes of providing information for the diagnosis, prevention, or treatment of any disease or impairment of, or the assessment of, the health of human beings. Typical divisions of a clinical laboratory include hematology, cytology, bacteriology, histology, biochemistry, medical toxicology, and serology.

Contacts:

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  • F. DANIEL JACKSON, MD, PA D/B/A LABWORK LLC
  • Address : 130 PENNSYLVANIA AVE
  • Region : CUMBERLAND, MD
  • NPI : 1639187289
  • Phone : 3017227270
  • Fax : 3017227274
  • Postalcode : 215024236

Authorized official :

{:AUTHORIZED_OFFICIAL_FIRST_NAME:} {:AUTHORIZED_OFFICIAL_MIDDLE_NAME:} {:AUTHORIZED_OFFICIAL_LAST_NAME:}
  • Phone : 3017593817
  • Title or position : PRESIDENT
  • Credentials : M.D.

Reference NPI Information. Full replica of the CMS (NPPES) NPI record

Field Name Value
Provider First Line Business Practice Location Address130 PENNSYLVANIA AVE
The first line location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
Provider Business Practice Location Address City NameCUMBERLAND
The city name in the location address of the provider being identified.
Provider Business Practice Location Address State NameMD
The State or Province name in the location address of the provider being identified.
Provider Business Practice Location Address Postal Code215024236
The postal ZIP or zone code in the location address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available.
Provider Business Practice Location Address Telephone Number3017227270
The telephone number associated with the location address of the provider being identified.
Provider Business Practice Location Address Fax Number3017227274
The fax number associated with the location address of the provider being identified.
NPI1639187289
10-position all-numeric identification number assigned by the NPS to uniquely identify a health care provider.
Healthcare Provider Taxonomy 1291U00000X
(1) A clinical laboratory is a facility for the biological, microbiological, serological, chemical, immunohematological, hematological, biophysical, cytological, pathological, or other examination of materials derived from the human body for the purpose of providing information for the diagnosis, prevention, or treatment of any disease or impairment of, human beings. These examinations also include procedures to determine, measure, or otherwise describe the presence or absence of various substances or organisms in the body. Facilities only collecting or preparing specimens (or both) or only serving as a mailing service and not performing testing are not considered clinical laboratories. (2) Any facility that examines materials from the human body for purposes of providing information for the diagnosis, prevention, or treatment of any disease or impairment of, or the assessment of, the health of human beings. Typical divisions of a clinical laboratory include hematology, cytology, bacteriology, histology, biochemistry, medical toxicology, and serology.
Provider Enumeration Date08.03.2006
The date the provider was assigned a unique identifier (assigned an NPI).
Last Updated07.08.2007
The date that a record was last updated or changed.
Entity TypeOrganization
Code describing the type of health care provider that is being assigned an NPI. Codes are:
  • 1 = (Person): individual human being who furnishes health care;
  • 2 = (Non-person): entity other than an individual human being that furnishes health care (for example, hospital, SNF, hospital subunit, pharmacy, or HMO).
Provider Organization Name (Legal Business Name)F. DANIEL JACKSON, MD, PA D/B/A LABWORK LLC
Provide organization name (legal business name used to file tax returns with the IRS). The Organization Name field allows the following special characters: ampersand, apostrophe, "at" sign, colon, comma, forward slash, hyphen, left and right parentheses, period, pound sign, quotation mark, and semi-colon. A field cannot contain all special characters.
Provider First Line Business Mailing AddressPO BOX 1701
The first line mailing address of the provider being identified. This data element may contain the same information as "Provider first line location address".
Provider Business Mailing Address City NameCUMBERLAND
The City name in the mailing address of the provider being identified. This data element may contain the same information as "Provider location address City name".
Provider Business Mailing Address State NameMD
The State or Province name in the mailing address of the provider being identified. This data element may contain the same information as "Provider location address State name".
Provider Business Mailing Address Postal Code215011701
The postal ZIP or zone code in the mailing address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available. This data element may contain the same information as "Provider location address postal code".
Provider Business Mailing Address Telephone Number3017593817
The telephone number associated with mailing address of the provider being identified. This data element may contain the same information as "Provider location address telephone number".
Provider Business Mailing Address Fax Number3017593286
The fax number associated with the mailing address of the provider being identified. This data element may contain the same information as "Provider location address fax number".
Authorized Official Last NameJACKSON
The last name of the person authorized to submit the NPI application or to change NPS data for a health care provider.
Authorized Official First NameF
The first name of the authorized official
Authorized Official Middle NameDANIEL
The middle name of the authorized official
Authorized Official Title or PositionPRESIDENT
The title or position of the authorized official
Authorized Official Name Prefix TextDR.
Authorized Official Name Prefix Text
Authorized Official Credential TextM.D.
Authorized Official Credential Text
Authorized Official Telephone Number3017593817
The 10-position telephone number of the authorized official.
Healthcare Provider Taxonomy Code #1291U00000X
The Health Care Provider Taxonomy code is a unique alphanumeric code, ten characters in length. The code set is structured into three distinct "Levels" including Provider Type, Classification, and Area of Specialization.
Healthcare Provider Taxonomy 1Clinical Medical Laboratory
(1) A clinical laboratory is a facility for the biological, microbiological, serological, chemical, immunohematological, hematological, biophysical, cytological, pathological, or other examination of materials derived from the human body for the purpose of providing information for the diagnosis, prevention, or treatment of any disease or impairment of, human beings. These examinations also include procedures to determine, measure, or otherwise describe the presence or absence of various substances or organisms in the body. Facilities only collecting or preparing specimens (or both) or only serving as a mailing service and not performing testing are not considered clinical laboratories. (2) Any facility that examines materials from the human body for purposes of providing information for the diagnosis, prevention, or treatment of any disease or impairment of, or the assessment of, the health of human beings. Typical divisions of a clinical laboratory include hematology, cytology, bacteriology, histology, biochemistry, medical toxicology, and serology.
Provider License Number 1939
Certain taxonomy selections will require you to enter your license number and the state where the license was issued. Select Foreign Country in the state drop down box if the license was issued outside of United States. The License Number field allows the following special characters: ampersand, apostrophe, colon, comma, forward slash, hyphen, left and right parentheses, period, pound sign, quotation mark, and semi-colon. A field cannot contain all special characters. DO NOT report the Social Security Number (SSN), IRS Individual Taxpayer Identification Number (ITIN) in this section.
Provider License Number State Code 1MD
Healthcare Provider Primary Taxonomy Switch 1Y
Primary Taxonomy:
  • X - The primary taxonomy switch is Not Answered;
  • Y - The taxonomy is the primary taxonomy (there can be only one per NPI record);
  • N - The taxonomy is not the primary taxonomy.
X

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