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Individual

DR. ROGER L JACKMAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
3400 BUTTONWOOD DR STE C, COLUMBIA, MO 65201-3720
(573) 443-0551
(573) 442-2959
Mailing address
2269 E BUFFALO DR, COLUMBIA, MO 65202-6683
(573) 214-0008
(573) 442-2959

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
R8620
MO

Other

Enumeration date
09/15/2006
Last updated
07/09/2007
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