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Organization

WILLIAM G. JACKSON, M.D.,P.A.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
WILLIAM JACKSON (OWNER/PHYSICIAN)
(662) 287-4481
Entity
Organization

Contact information

Practice address
202 ALCORN DR, CORINTH, MS 38834-9701
(662) 287-4481
(662) 287-4368
Mailing address
202 ALCORN DR, CORINTH, MS 38834-9701
(662) 287-4481
(662) 287-4368

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
07322
MS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
04339516
MS
Enumeration date
07/26/2006
Last updated
11/05/2010
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