Organization
DR JOE A JACKSON, MD PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOE A JACKSON MD (OWNER)
(850) 469-1330
Entity
Organization
Contact information
Practice address
224 E GARDEN ST, SUITE 5B BOX J16, PENSACOLA, FL 32502-6068
(850) 469-1330
(850) 469-1554
Mailing address
224 E GARDEN ST, SUITE 5B BOX J16, PENSACOLA, FL 32502-6068
(850) 469-1330
(850) 469-1554
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
85613
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00013024
—
MS
Enumeration date
10/13/2015
Last updated
10/13/2015
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