Individual
DR. JAMES EDWARD JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
212 E MAIN ST, MOREHEAD, KY 40351-1620
(606) 784-8518
(606) 784-8899
Mailing address
212 E MAIN ST, MOREHEAD, KY 40351-1620
(606) 784-8518
(606) 784-8899
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
14467
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
64144678
—
KY
Enumeration date
12/11/2006
Last updated
07/01/2011
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