Individual
DR. TIFFANY L JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
O.D.
Contact information
Practice address
273 N FRONT ST, WILMINGTON, NC 28401-3907
(910) 341-4556
(866) 363-8330
Mailing address
2322 JAMES B WHITE HWY N, WHITEVILLE, NC 28472-8970
(910) 914-6442
(910) 914-6425
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1900
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
89093N2
—
NC
Enumeration date
04/11/2007
Last updated
11/22/2022
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