Individual
DR. LARRY RONALD JACKSON II
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2301 ERWIN RD, DURHAM, NC 27710-0001
(919) 970-6972
Mailing address
2301 ERWIN RD, DURHAM, NC 27710-0001
Taxonomy
Speciality
Code
Description
License number
State
207RC0001X
Clinical Cardiac Electrophysiology Physician
Primary
2011-00893
NC
Other
Enumeration date
05/14/2008
Last updated
07/23/2017
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