Individual
DR. MICHAEL D JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
602 N 6TH ST, GARDEN CITY, KS 67846-5509
(620) 272-2519
Mailing address
PO BOX 803929, KANSAS CITY, MO 64180-3929
(800) 953-0104
(303) 765-6670
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
04-19573
KS
Other
Enumeration date
05/16/2006
Last updated
06/03/2024
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