Individual
COREY T JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
51 N DUNLAP ST, MEMPHIS, TN 38105-4624
(866) 870-5570
Mailing address
400 INNOVATION DR, MEMPHIS, TN 38152-0001
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
TN
Other
Enumeration date
05/15/2026
Last updated
05/15/2026
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