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Individual

DR. JARRYD A JACKSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
PHARMD

Contact information

Practice address
1265 HIGHWAY 54 W, SUITE #201, FAYETTEVILLE, GA 30214-4548
(678) 435-3046
Mailing address
180 JACKSON ST NE, UNIT #3412, ATLANTA, GA 30312-1303
(404) 583-1379

Taxonomy

Speciality
Code
Description
License number
State
183500000X
Pharmacist
46840
TX
183500000X
Pharmacist
PS42485
FL
183500000X
Pharmacist
Primary
RPH024513
GA

Other

Enumeration date
02/27/2012
Last updated
02/27/2012
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