Individual
ATIBA DIARRA JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
4160 LITTLE YORK RD, STE 10, DAYTON, OH 45414-5803
(937) 415-9100
(937) 415-9191
Mailing address
4160 LITTLE YORK RD, STE 10, DAYTON, OH 45414-5803
(937) 415-9100
(937) 415-9191
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
35.089443
OH
Other
Enumeration date
05/22/2007
Last updated
09/16/2016
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