Individual
DR. JACQUELINE KAY JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1621 NE WALDO RD, GAINESVILLE, FL 32609-3900
(352) 264-8272
(352) 264-8304
Mailing address
1200 NE 55TH BLVD, GAINESVILLE, FL 32641-2759
(352) 264-8272
(352) 264-8304
Taxonomy
Speciality
Code
Description
License number
State
207QA0505X
Adult Medicine Physician
Primary
ME 0058078
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
010829000
—
FL
Enumeration date
01/22/2010
Last updated
02/25/2019
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