Organization
JEFFERSON COUNTY PULMONARY & SLEEP MEDICINE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. FARRIS JACKSON JR. MD (PHYSICIAN)
(636) 937-3121
Entity
Organization
Contact information
Practice address
1390 US HIGHWAY 61 STE 2300, FESTUS, MO 63028-4121
(636) 937-3121
(636) 937-4423
Mailing address
807 CRAIG FOREST LN, KIRKWOOD, MO 63122-5567
(636) 937-3121
(636) 937-4423
Taxonomy
Speciality
Code
Description
License number
State
207RP1001X
Pulmonary Disease Physician
Primary
R9F09
MO
Other
Enumeration date
02/01/2007
Last updated
10/05/2007
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