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Organization
SAMANTHA JACKSON MD PLLC
Active
Organization
SAMANTHA JACKSON MD PLLC
Active
Parent organization
SAMANTHA L JACKSON MD
Organization subpart
Yes
Provider details
NPI number
Legal business name
SAMANTHA L JACKSON MD
Authorized official
SAMANTHA L JACKSON M.D. (OWNER)
(580) 726-2226
Entity
Organization
Contact information
Practice address
415 W FOREST LN, HOBART, OK 73651-1645
(580) 726-2226
(580) 726-8425
Mailing address
415 W FOREST LN, HOBART, OK 73651-1645
(580) 726-2226
(580) 726-8425
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
19876
OK
Other
Enumeration date
07/01/2013
Last updated
01/16/2017
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