Individual
DR. LERON C JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD, MPH
Contact information
Practice address
590 MANNING DR, CHAPEL HILL, NC 27599-6616
(919) 966-0210
Mailing address
615 DOUGLAS ST, DURHAM, NC 27705-6616
(919) 767-0277
(919) 797-1250
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
2011-00809
NC
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
13190004
—
NC
Enumeration date
06/25/2007
Last updated
07/30/2021
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