Individual
THOMAS MORTON JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3700 CALIFORNIA ST, SAN FRANCISCO, CA 94118
(415) 600-2200
(415) 750-6001
Mailing address
PO BOX 26060, FRESNO, CA 93729
(559) 455-4000
(559) 455-4004
Taxonomy
Speciality
Code
Description
License number
State
207ZP0105X
Clinical Pathology/Laboratory Medicine Physician
Primary
G28421
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00G284210
—
CA
Enumeration date
03/21/2006
Last updated
02/12/2008
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