Individual
CHARLES E JACKSON JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
107 FAIRVIEW PARK DR, DUBLIN, GA 31021-2501
(478) 864-3448
(478) 864-1288
Mailing address
1506 TELFAIR ST, DUBLIN, GA 31021-3908
(478) 272-3446
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
014513
GA
Other
Enumeration date
05/15/2007
Last updated
01/07/2019
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