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Individual
MARK F JACKSON
Active
Individual
MARK F JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
40009
KY
207LA0401X
Addiction Medicine (Anesthesiology) Physician
Primary
ME142795
FL
207LP2900X
Pain Medicine (Anesthesiology) Physician
ME142795
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000566553
ANTHEM
—
Enumeration date
02/06/2007
Last updated
09/29/2026
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