Individual
SCARLEY C JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1533 ALABAMA AVE SW, BIRMINGHAM, AL 35211-1831
(205) 203-3369
Mailing address
1533 ALABAMA AVE SW, BIRMINGHAM, AL 35211-1831
(205) 203-3369
Taxonomy
Speciality
Code
Description
License number
State
342000000X
Transportation Network Company
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
B-106
—
AL
Enumeration date
08/19/2021
Last updated
08/19/2021
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