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Individual

DR. LORREN JACKSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
530 CHICAGO AVE, MINNEAPOLIS, MN 55415-1518
(612) 215-6300
Mailing address
530 CHICAGO AVE, MINNEAPOLIS, MN 55415-1518
(612) 215-6300

Taxonomy

Speciality
Code
Description
License number
State
207ZF0201X
Forensic Pathology Physician
Primary
52249
MN
207ZP0101X
Anatomic Pathology Physician
A86673
CA

Other

Enumeration date
05/07/2007
Last updated
11/12/2014
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