Individual
MR. ALFRED B JACKSON III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C, MBA
Contact information
Practice address
501 W 14TH ST, SUITE 4154, WILMINGTON, DE 19801-1013
(302) 428-4654
Mailing address
797 SLATE HILL DR, OXFORD, PA 19363-1833
(610) 932-7007
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
C5-0000216
DE
Other
Enumeration date
04/02/2007
Last updated
04/06/2010
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