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Individual

ELI NOAH JACKSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
PA-C

Contact information

Practice address
942 HIGHWAY 65 N, MARSHALL, AR 72650-7772
(888) 518-1418
(870) 895-2164
Mailing address
101 W MAIN ST, HARDY, AR 72542-9566
(870) 856-2133

Taxonomy

Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PT2019-050
AR

Other

Enumeration date
11/25/2019
Last updated
11/25/2019
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