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Individual

DR. JACKSON GENANT

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
730 MALCOLM BLVD STE 230, CONNELLY SPRINGS, NC 28612-8079
(828) 580-2811
(828) 580-7083
Mailing address
730 MALCOLM BLVD STE 230, CONNELLY SPRINGS, NC 28612-8079
(828) 580-2811
(828) 580-7083

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
9800052
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1376586909
NC
Enumeration date
06/13/2006
Last updated
04/20/2018
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