Organization
E-TOWN NEUROSURGERY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
THAD R. JACKSON (PHYSICIAN AND OWNER)
(270) 769-5551
Entity
Organization
Contact information
Practice address
1700 RING RD, ELIZABETHTOWN, KY 42701-9497
(270) 769-5551
(270) 765-3919
Mailing address
1700 RING RD, ELIZABETHTOWN, KY 42701-9497
(270) 769-5551
(270) 765-3919
Taxonomy
Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
Primary
—
—
363A00000X
Physician Assistant
—
—
Other
Enumeration date
05/09/2007
Last updated
01/13/2009
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