Individual
DR. WYNN K JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
2 BENEDICT PL, GREENWICH, CT 06830-5358
(203) 661-7575
Mailing address
2 BENEDICT PL, GREENWICH, CT 06830-5358
(203) 661-7575
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
029759
CT
Other
Enumeration date
07/14/2008
Last updated
07/14/2008
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