Individual
CAROLE LYNN JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
525 WESTERN AVENUE, SUITE 303, CONWAY, AR 72034-6135
(501) 327-9497
(501) 327-3478
Mailing address
2519 COLLEGE AVENUE, CONWAY, AR 72034-6135
(501) 327-6547
(501) 327-9715
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
C 5812
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
113505001
—
AR
Enumeration date
02/01/2006
Last updated
03/07/2023
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