Individual
DR. DAMIEN JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
6161 S YALE AVE, TULSA, OK 74136-1902
(918) 682-5501
Mailing address
6161 S YALE AVE, TULSA, OK 74136-1902
(184) 942-2009
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
34931
OK
390200000X
Student in an Organized Health Care Education/Training Program
—
OH
Other
Enumeration date
04/06/2016
Last updated
06/25/2019
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