# JAMES JACKSON, MD LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1558858068
- **Authorized official:** TAWANA HILL (CREDENTIALING SPECIALIST)
- **Authorized official phone:** (405) 896-7901

## Contact information

- **Practice address:** 3330 NW 56TH ST STE 612, OKLAHOMA CITY, OK 73112-4470
- **Practice address phone:** (405) 610-8810
- **Mailing address:** 13924 QUAIL POINTE DR STE B, OKLAHOMA CITY, OK 73134-1024
- **Mailing address phone:** (405) 896-7901
- **Mailing address fax:** (405) 242-4074

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QR0400X | Rehabilitation Clinic/Center | 27258 | OK | Yes |

## Other

- **Enumeration date:** 04/19/2018
- **Last updated:** 04/19/2018