Individual
DR. KIRK LEE JACKSON
Active
Individual
DR. KIRK LEE JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
MD18273
AL
207R00000X
Internal Medicine Physician
Primary
18273
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
110160764
RAILROAD MEDICARE
AL
05
—
1316977945
—
AL
01
—
51077099
BLUE CROSS & BLUE SHIELD
AL
05
—
77099
—
AL
Enumeration date
07/03/2006
Last updated
10/05/2011
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