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Organization
JACKSON RURAL HEALTH CLINIC P A
Active
Organization
JACKSON RURAL HEALTH CLINIC P A
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DANNY JACKSON D.O. (OWNER)
(662) 873-4361
Entity
Organization
Contact information
Practice address
29 S FOURTH ST, ROLLING FORK, MS 39159-5146
(662) 873-4361
(662) 873-2921
Mailing address
PO BOX 520, ROLLING FORK, MS 39159-0520
(662) 873-4361
(662) 873-2921
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
253949
MS
Other
Enumeration date
06/29/2006
Last updated
12/04/2012
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