Individual
DR. BRIAN D JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPM
Contact information
Practice address
1215 HATCHER LN, COLUMBIA, TN 38401-3531
(615) 220-8788
(615) 220-8688
Mailing address
3024 BUSINESS PARK CIR, GOODLETTSVILLE, TN 37072-3132
(615) 239-2018
(615) 851-2018
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
436
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3352132
—
TN
01
—
4042682
BLUE CROSS
TN
01
—
480034585
RAILROAD MEDICARE
TN
01
—
DC1001
RAILROAD MEDICARE GROUP
TN
Enumeration date
06/23/2005
Last updated
03/15/2023
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