Individual
SAMANTHA JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
415 W FOREST LN, HOBART, OK 73651-1645
(580) 726-2226
(580) 726-8425
Mailing address
PO BOX 826, HOBART, OK 73651-0826
(580) 726-2226
(580) 726-8425
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
19876
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100131750D
—
OK
Enumeration date
01/18/2006
Last updated
09/25/2025
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