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Individual

MAX JACKSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
850 MILL ST, SUITE 100, RENO, NV 89502-1413
(775) 982-5000
(775) 982-5417
Mailing address
780 KUENZLI ST, SUITE 202, RENO, NV 89502-1011
(775) 982-4590
(775) 982-4595

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
R3H65
MO
207QG0300X
Geriatric Medicine (Family Medicine) Physician
Primary
12030
NV

Other

Enumeration date
06/13/2006
Last updated
09/12/2007
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