Individual
FRANK WILSON JACKSON III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
423 N 21ST ST, SUITE 100, CAMP HILL, PA 17011-2207
(717) 761-0930
(717) 761-0465
Mailing address
423 N 21ST ST, SUITE 100, CAMP HILL, PA 17011-2207
(717) 761-0930
(717) 761-0465
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
MD055416L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0016834680003
—
PA
01
—
01024101
CAPITAL BLUE CROSS
PA
01
—
100012586
RAILROAD MEDICARE
PA
01
—
527552
HIGHMARK BLUE SHIELD
PA
01
—
5333615
AETNA US HEALTHCARE
PA
01
—
G84061
HEALTHAMERICA
PA
Enumeration date
07/18/2005
Last updated
09/15/2020
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