Individual
ANEE SOPHIA JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
550 PEACHTREE ST NE STE 1430, ATLANTA, GA 30308-2242
(404) 778-3712
(404) 778-0820
Mailing address
125 PARKWOOD LN, DECATUR, GA 30030-2857
(913) 221-9410
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
4301507139
MI
208600000X
Surgery Physician
Primary
96960
GA
Other
Enumeration date
04/10/2015
Last updated
08/23/2023
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