Organization
BRIAN D. JACKSON, DPM, LLC
Active
Organization
BRIAN D. JACKSON, DPM, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BRIAN DOUGLAS JACKSON DPM (PRESIDENT)
(931) 380-0353
Entity
Organization
Contact information
Practice address
1215 HATCHER LN, COLUMBIA, TN 38401-3531
(931) 380-0353
Mailing address
1215 HATCHER LN, COLUMBIA, TN 38401-3531
(931) 380-0353
Taxonomy
Speciality
Code
Description
License number
State
213ES0131X
Foot Surgery Podiatrist
Primary
436
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2740069
UNITED HEALTHCARE
—
01
—
3352132
MEDICARE GROUP PIN
—
01
—
3414014
CIGNA
—
01
—
4042682
BLUE CROSS OF TN
—
01
—
480034585
RAILROAD MEDICARE
—
01
—
DC1001
RAILROAD MEDICARE GROUP
TN
Enumeration date
08/15/2007
Last updated
02/06/2008
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