Individual
DR. RICKY JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
7443 KEYNON CV, MEMPHIS, TN 38125-2737
(919) 559-4876
Mailing address
PO BOX 25854, MEMPHIS, TN 38125-8011
Taxonomy
Speciality
Code
Description
License number
State
343900000X
Non-emergency Medical Transport (VAN)
—
—
347C00000X
Private Vehicle
Primary
—
—
Other
Enumeration date
05/31/2022
Last updated
05/31/2022
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