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Individual

ALISON W JACKSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
3577 MAIN AVE, DURANGO, CO 81301-4028
(970) 247-8008
(970) 247-8006
Mailing address
3577 MAIN AVE, DURANGO, CO 81301-4028
(970) 247-8008
(970) 247-8006

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
34888
CO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
01348887
CO
Enumeration date
01/18/2007
Last updated
07/24/2012
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