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Individual

DR. JAMES LEE JACKSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
101 MEDICAL HEIGHTS DR, SUITE M, FRANKFORT, KY 40601-4137
(502) 227-7538
(502) 227-9248
Mailing address
101 MEDICAL HEIGHTS DR, SUITE M, FRANKFORT, KY 40601-4137
(502) 227-7538
(502) 227-9248

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
23520
KY
207RP1001X
Pulmonary Disease Physician
Primary
23520
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000048738
ANTHEM BCBS
KY
01
1376542951
RAILROAD MEDICARE
KY
05
64235203
KY
05
65934895
KY
01
C30629
RAILROAD MEDICARE
KY
Enumeration date
07/18/2005
Last updated
04/20/2022
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