Individual
DR. DAVID NEAL JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1707 W CHARLESTON BLVD, #120, LAS VEGAS, NV 89102-2351
(702) 671-5140
(702) 385-2745
Mailing address
1701 W CHARLESTON BLVD, #215, LAS VEGAS, NV 89102-2325
(702) 968-4347
(702) 382-5388
Taxonomy
Speciality
Code
Description
License number
State
207VM0101X
Maternal & Fetal Medicine Physician
01065052A
IN
207VM0101X
Maternal & Fetal Medicine Physician
Primary
12911
NV
207VM0101X
Maternal & Fetal Medicine Physician
8687
MT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0017663
—
MT
01
—
01065052A
STATE LICENSE
IN
01
—
12911
STATE LICENSE
NV
01
—
8687
STATE LICENSE
MT
Enumeration date
09/20/2006
Last updated
04/23/2021
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