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Organization
JACKSONS POINT OF LIGHT FAMILY MEDICINE INC.
Active
Organization
JACKSONS POINT OF LIGHT FAMILY MEDICINE INC.
Active
Other names
JPL Family Medicine, Inc
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DERRIC N JACKSON (ADMINISTRATON/COO)
(334) 291-5255
Entity
Organization
Contact information
Practice address
1810 STADIUM DR, SUITE 210, PHENIX CITY, AL 36867-3177
(334) 291-5255
(877) 395-0710
Mailing address
PO BOX 1045, PHENIX CITY, AL 36868-1045
(334) 291-5255
(877) 395-0710
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
NULL
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Enumeration date
09/12/2007
Last updated
03/07/2023
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