Individual
DR. EDWARD LAWRENCE JACKSON
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
PHARM.D.
Contact information
Practice address
WAMC STOP A 2817 REILLY RD, MCXC PH, FORT BRAGG, NC 28310-0001
(910) 907-8680
(910) 907-8443
Mailing address
5821 WALDWICK RD, FAYETTEVILLE, NC 28311-3413
(910) 488-3349
Taxonomy
Speciality
Code
Description
License number
State
1835P1200X
Pharmacotherapy Pharmacist
Primary
11096
NC
Other
Enumeration date
12/27/2005
Last updated
07/08/2007
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