Individual
DR. PHILLIP GAYNOR JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
5500 ROCKTON WOOD WAY SW, ATLANTA, GA 30331-8904
(404) 494-9540
(404) 344-3706
Mailing address
5500 ROCKTON WOOD WAY SW, ATLANTA, GA 30331-8904
(404) 494-9540
(404) 344-3706
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
048248
GA
Other
Enumeration date
02/19/2007
Last updated
07/08/2007
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