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Organization
LARRY A. JACKSON, MD PC
Active
Organization
LARRY A. JACKSON, MD PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LARRY ARTHUR JACKSON MD (PRESIDENT)
(541) 726-0550
Entity
Organization
Contact information
Practice address
1717 CENTENNIAL BLVD, SUITE 7, SPRINGFIELD, OR 97477-3378
(541) 726-0550
(541) 726-7485
Mailing address
1717 CENTENNIAL BLVD, SUITE 7, SPRINGFIELD, OR 97477-3378
(541) 726-0550
(541) 726-7485
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
08513
OR
Other
Enumeration date
05/21/2013
Last updated
05/21/2013
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