# MARKUS JACKSON MD INC

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

## Provider details

- **NPI number:** 1770104606
- **Authorized official:** DR. MARKUS R JACKSON MD (PRESIDENT)
- **Authorized official phone:** (706) 288-8683

## Contact information

- **Practice address:** 4016 DALE RD, MODESTO, CA 95356-9268
- **Practice address phone:** (706) 288-8683
- **Mailing address:** 2412 37TH ST, SACRAMENTO, CA 95817-1302
- **Mailing address phone:** (706) 288-8683

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207LP2900X | Pain Medicine (Anesthesiology) Physician | — | NULL | Yes |
| 207LP2900X | Pain Medicine (Anesthesiology) Physician | — | — | Yes |

## Other

- **Enumeration date:** 05/01/2020
- **Last updated:** 05/01/2020