Individual
DR. ALVIN DERON JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
106 E BROAD ST, SAVANNAH, GA 31401-2917
(912) 527-1000
Mailing address
106 E BROAD ST, SAVANNAH, GA 31401-2917
(912) 527-1097
(912) 527-1126
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
066163
GA
207Q00000X
Family Medicine Physician
Primary
35064673
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003172519C
—
GA
Enumeration date
01/04/2006
Last updated
06/11/2019
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