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Individual

DR. MARGARET S MCCALLA-JACKSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
OD

Contact information

Practice address
2600 W 3RD ST, BLOOMINGTON, IN 47404-5227
(812) 336-5432
(812) 332-5084
Mailing address
9795 CROSSPOINT BLVD, SUITE 100, INDIANAPOLIS, IN 46256-3354
(317) 254-6480
(317) 259-8609

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
18001887A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000078730
BLUE CROSS
IN
05
100184230
IN
Enumeration date
06/14/2006
Last updated
09/09/2014
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