# W JACKSON ILIFF M.D., LLC

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

## Provider details

- **NPI number:** 1962739839
- **Authorized official:** W JACKSON ILIFF M.D. (OWNER)
- **Authorized official phone:** (410) 869-1990

## Contact information

- **Practice address:** 4 W ROLLING CROSSROADS, STE 7, CATONSVILLE, MD 21228-6280
- **Practice address phone:** (410) 869-1990
- **Mailing address:** 4 W ROLLING CROSSROADS, STE 7, CATONSVILLE, MD 21228-6280
- **Mailing address phone:** (410) 869-1990

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207W00000X | Ophthalmology Physician | D08485 | MD | Yes |

## Other

- **Enumeration date:** 11/12/2009
- **Last updated:** 11/12/2009

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 964451200 | — | MD |