# INGRID W. JACKSON, M.D., LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Faith Family Healthcare Clinic
- **Organization subpart:** No

## Provider details

- **NPI number:** 1205336187
- **Authorized official:** TINA WHITE (OWNER)
- **Authorized official phone:** (405) 418-0125

## Contact information

- **Practice address:** 740 SIGNAL RIDGE DR, EDMOND, OK 73013-3675
- **Practice address phone:** (405) 418-0125
- **Practice address fax:** (405) 216-3454
- **Mailing address:** 740 SIGNAL RIDGE DR, EDMOND, OK 73013-3675
- **Mailing address phone:** (405) 418-0125
- **Mailing address fax:** (405) 216-3454

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | 15786 | OK | Yes |

## Other

- **Enumeration date:** 02/16/2018
- **Last updated:** 10/28/2024