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Individual
MORRIS B JACKSON
Active
Individual
MORRIS B JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
01039636A
IN
208800000X
Urology Physician
Primary
22181
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00895267
RAILROAD MEDICARE
KY
05
—
201028460
—
IN
05
—
64221815
—
KY
01
—
P00314088
RAILROAD MEDICARE
KY
Enumeration date
05/03/2006
Last updated
01/29/2016
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