Individual
JENNIFER ELLIS JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
3401 N BROAD ST, TEMPLE UNIVERSITY HOSPITAL, PHILADELPHIA, PA 19140-5103
(215) 707-5030
(215) 707-3494
Mailing address
PO BOX 828065, TEMPLE EMERGENCY MED ASSOC, PHILADELPHIA, PA 19182-8065
(800) 666-2455
(610) 617-6280
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
MD430844
PA
Other
Enumeration date
07/02/2007
Last updated
09/29/2009
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