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Organization
LAWRENCE RICHARD JACKSON JR. MD
Active
Organization
LAWRENCE RICHARD JACKSON JR. MD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LAWRENCE RICHARD JACKSON JR. MD (OWNER)
(931) 296-3555
Entity
Organization
Contact information
Practice address
104 HILLWOOD DR, WAVERLY, TN 37185-2116
(931) 296-3555
(931) 296-9085
Mailing address
PO BOX 270, WAVERLY, TN 37185-0270
(931) 296-3555
(931) 296-9085
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
NULL
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Enumeration date
06/19/2007
Last updated
11/21/2025
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