Individual
MR. DAVID RAY JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
NP
Contact information
Practice address
2301 N ASHLEY ST, VALDOSTA, GA 31602-2620
(229) 270-2403
(229) 468-0688
Mailing address
204 E 4TH ST, OCILLA, GA 31774-1539
(229) 468-9166
(229) 468-9188
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
RN154383
GA
Other
Enumeration date
02/12/2007
Last updated
07/25/2025
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