Individual
JOHN B JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
4016 SUN CITY CENTER BLVD, SUN CITY CENTER, FL 33573-5256
(813) 634-3301
Mailing address
3572 BRODHEAD RD, SUITE 201, MONACA, PA 15061-3101
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
MD433732
PA
2085R0202X
Diagnostic Radiology Physician
Primary
ME163263
FL
Other
Enumeration date
09/10/2007
Last updated
09/13/2023
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