Individual
BROOKE A JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
245 E NC HIGHWAY 54, SUITE 202, DURHAM, NC 27713-2551
(919) 294-9440
(919) 237-3899
Mailing address
245 EAST NC HIGHWAY 54, SUITE 202, DURHAM, NC 27713
(919) 294-9440
(919) 237-3899
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
036093014
IL
207N00000X
Dermatology Physician
Primary
2013-00616
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01633086
BCBS
—
Enumeration date
11/15/2006
Last updated
08/11/2021
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