Individual
DR. KATHY JO JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
117 W PATERSON ST, KALAMAZOO, MI 49007-2557
(269) 349-2641
(269) 349-2898
Mailing address
1003 PINEHURST BLVD, KALAMAZOO, MI 49006-2110
(269) 349-2641
(269) 349-2898
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
070748
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
104509048
—
MI
Enumeration date
12/01/2006
Last updated
12/27/2022
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