Individual
DR. AMIE ELISSA JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1700 NICHOLASVILLE RD STE 1100, LEXINGTON, KY 40503-1466
(859) 276-0414
(859) 276-3765
Mailing address
1700 NICHOLASVILLE RD STE 1100, LEXINGTON, KY 40503-1466
(859) 276-0414
(859) 276-3765
Taxonomy
Speciality
Code
Description
License number
State
207RH0003X
Hematology & Oncology Physician
Primary
56752
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7100622180
—
KY
Enumeration date
06/30/2009
Last updated
04/26/2023
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