Individual
DENNIS MARK JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
MSC06 3870 1 UNIVERSITY OF NEW MEXICO, UNM STUDENT HEALTH CENTER, ALBUQUERQUE, NM 87131-0001
(505) 277-3136
(505) 277-5668
Mailing address
MSC06 3870 1 UNIV OF NM, UNM STUDENT HEALTH CENTER, ALBUQUERQUE, NM 87131-0001
(505) 277-3136
(505) 277-5668
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
70142
NM
Other
Enumeration date
11/20/2006
Last updated
07/08/2007
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