Individual
DR. JACK JERRY SALAH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3599 UNIVERSITY BLVD S, SUITE 901, JACKSONVILLE, FL 32216-4252
(904) 398-6971
(904) 398-2497
Mailing address
8236 SHADY GROVE RD, JACKSONVILLE, FL 32256-7361
(904) 645-9655
Taxonomy
Speciality
Code
Description
License number
State
207RP1001X
Pulmonary Disease Physician
Primary
ME0041346
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
045079100
—
FL
Enumeration date
08/03/2005
Last updated
01/25/2010
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