Individual
DR. THOMAS COZATT JACKSON JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
470 LINDEN AVE, HARRODSBURG, KY 40330-1871
(859) 734-4307
(859) 734-4300
Mailing address
470 LINDEN AVE STE 3-4, HARRODSBURG, KY 40330-1871
(859) 734-4307
(859) 734-4300
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
29222
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
64292220
—
KY
Enumeration date
02/07/2006
Last updated
07/08/2007
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