Individual
PAUL JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
600 ELIZABETH ST, GME, CORPUS CHRISTI, TX 78404
(361) 861-1864
Mailing address
600 ELIZABETH ST, GME, CORPUS CHRISTI, TX 78404
(361) 861-1864
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
05035
KY
207P00000X
Emergency Medicine Physician
Primary
5298
TN
207R00000X
Internal Medicine Physician
05035
KY
208M00000X
Hospitalist Physician
05035
KY
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/27/2018
Last updated
08/29/2024
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