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Individual

DR. GINECE JASMINE JACKSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
2000 W BETHANY HOME RD, PHOENIX, AZ 85015-2443
(877) 749-7428
Mailing address
1776 WOODSTEAD CT STE 208, THE WOODLANDS, TX 77380-1480
(877) 749-7428
(512) 628-3314

Taxonomy

Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
54090
AZ

Other

Enumeration date
09/12/2012
Last updated
03/02/2021
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