Individual
DR. JEANETTE HELEN JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
75 AVENUE B, RICHWOOD, WV 26261-1236
(304) 846-2573
(304) 846-6389
Mailing address
75 AVENUE B, RICHWOOD, WV 26261-1236
(304) 846-2573
(304) 846-6389
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
1780
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6000951000
—
WV
Enumeration date
10/04/2006
Last updated
04/03/2008
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