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Organization
F. DANIEL JACKSON, MD, PA
Active
Organization
F. DANIEL JACKSON, MD, PA
Active
Other names
The Imaging Center
Organization subpart
No
Provider details
NPI number
Authorized official
DR. F. DANIEL JACKSON MD, PA (PRESIDENT/OWNER)
(301) 759-3410
Entity
Organization
Contact information
Practice address
715 WILLIAMS STREET, CUMBERLAND, MD 21502
(301) 759-3410
(301) 759-3522
Mailing address
PO BOX 1692, CUMBERLAND, MD 21501-1692
(301) 759-3817
(301) 759-3043
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
—
—
261QR0200X
Radiology Clinic/Center
Primary
D0020433
MD
261QR0200X
Radiology Clinic/Center
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
305591400
—
MD
05
—
440082800
—
MD
Enumeration date
07/23/2007
Last updated
05/17/2011
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