# MORRIS B JACKSON

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1477511921
- **Gender:** Man
- **Credential:** MD

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208800000X | Urology Physician | 01039636A | IN | — |
| 208800000X | Urology Physician | 22181 | KY | Yes |

## Other

- **Enumeration date:** 05/03/2006
- **Last updated:** 01/29/2016

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 00895267 | RAILROAD MEDICARE | KY |
| 05 | — | 201028460 | — | IN |
| 05 | — | 64221815 | — | KY |
| 01 | — | P00314088 | RAILROAD MEDICARE | KY |