Individual
JACKSON LANCE RANKIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1 MEDICAL CENTER BLVD, WINSTON SALEM, NC 27157-0001
(336) 716-2011
Mailing address
1654 OVERBROOK RD APT B10, RICHMOND, VA 23220-1362
(540) 230-9232
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
03/22/2024
Last updated
03/22/2024
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