Individual
DR. BLAKE BALLARD JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
800 ROSE ST, MN 275, LEXINGTON, KY 40536-0293
(859) 373-6162
Mailing address
800 ROSE ST, MN275, LEXINGTON, KY 40536-0293
(859) 323-6162
(859) 257-8934
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
03/28/2023
Last updated
03/28/2023
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