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Individual

DR. ANTHONY WADE JACKSON SR.

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
152 HIGHWAY 7 S, OXFORD, MS 38655-5392
(662) 488-8878
Mailing address
152 HIGHWAY 7 S, OXFORD, MS 38655-5392
(662) 488-8878

Taxonomy

Speciality
Code
Description
License number
State
2084P0804X
Child & Adolescent Psychiatry Physician
Primary
14917
MS

Other

Enumeration date
01/27/2007
Last updated
09/09/2015
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