Individual
DR. BRENDAN ROBERT JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1600 CLIFTON RD NE, MS E-92, ATLANTA, GA 30329-4018
(404) 498-1829
Mailing address
1600 CLIFTON RD NE, MS E-92, ATLANTA, GA 30329-4018
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
064571
GA
2083P0901X
Public Health & General Preventive Medicine Physician
Primary
064571
GA
Other
Enumeration date
12/24/2007
Last updated
03/01/2013
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