Individual
MICHAEL JACKSON JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2451 UNIVERSITY HOSPITAL DR BLDG ROOM719, MOBILE, AL 36617-2300
(251) 445-8282
Mailing address
2451 UNIVERSITY HOSPITAL DR BLDG ROOM719, MOBILE, AL 36617-2300
(251) 445-8282
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
L.5962R
AL
390200000X
Student in an Organized Health Care Education/Training Program
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Other
Enumeration date
03/27/2023
Last updated
10/12/2023
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