Individual
JOHN W JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1698 E MCANDREWS RD, SUITE 400, MEDFORD, OR 97504-5589
(541) 732-6000
(541) 732-6005
Mailing address
PO BOX 3158, PORTLAND, OR 97208-3158
(503) 215-6494
(503) 215-6644
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
MD13335
OR
Other
Enumeration date
10/05/2006
Last updated
01/14/2010
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