Individual
CHARLES LESLIE JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RPH
Contact information
Practice address
100 EAST ST, TEXARKANA, AR 71854-6304
(870) 772-6969
(870) 774-0912
Mailing address
100 EAST ST, TEXARKANA, AR 71854-6304
(870) 772-6969
(870) 774-0912
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
PD05726
AR
Other
Enumeration date
10/26/2016
Last updated
10/26/2016
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