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Individual

ALBERT JEROME JACKSON JR.

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
2710 SAINT FRANCIS DR, STE 410, WATERLOO, IA 50702-5619
(319) 272-5000
Mailing address
2710 SAINT FRANCIS DR STE 410, WATERLOO, IA 50702-5634
(319) 272-5000

Taxonomy

Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
37967
IA
207L00000X
Anesthesiology Physician
85264
WI
207L00000X
Anesthesiology Physician
85529
SC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
BP2-0023863
INSTITUTIONAL PERMIT
Enumeration date
05/26/2007
Last updated
01/06/2026
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