Individual
DR. ANGELA PATRICE JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
808 COMMERCE BLVD, SUITE A, RIVERDALE, GA 30296-7192
(770) 996-9191
(770) 996-5298
Mailing address
808 COMMERCE BLVD, SUITE A, RIVERDALE, GA 30296-7192
(770) 996-9191
(770) 996-5298
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
001627
GA
Other
Enumeration date
04/15/2008
Last updated
10/25/2011
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