Individual
DR. LARRY K JACKSON
Active
Individual
DR. LARRY K JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207RP1001X
Pulmonary Disease Physician
Primary
00006718
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
410564
UNITED HEALTHCARE
AL
01
—
51087222
BLUE CROSS
AL
01
—
87222
CIGNA
AL
Enumeration date
06/09/2006
Last updated
01/22/2010
Update your record
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