Individual
MR. DARRELL M JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2336 GODDARD PARKWAY, SALISBURY, MD 21801
(410) 334-6961
(410) 334-6960
Mailing address
2336 GODDARD PARKWAY, SALISBURY, MD 21801
(410) 334-6961
(410) 334-6960
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
259147000
MAGELLAN GROUP
MD
01
—
517251
UHC MAMSI GROUP
—
05
—
609500300
—
MD
05
—
609500303
—
MD
05
—
609550001
—
MD
05
—
609550004
—
MD
01
—
LM49EA
CAREFIRST BCBS GROUP
MD
01
—
R968
CAREFIRST BCBS GROUP
DC
Enumeration date
11/02/2006
Last updated
09/18/2008
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