Individual
CHARLES MARK JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3 E APPLEBY RD STE 201, FAYETTEVILLE, AR 72703-3158
(479) 404-1100
(479) 404-1101
Mailing address
3 E APPLEBY RD STE 201, FAYETTEVILLE, AR 72703-3158
(479) 404-1100
(479) 404-1101
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
E-9270
AR
Other
Enumeration date
05/04/2010
Last updated
06/19/2023
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