Individual
DOUGLAS RAY JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RPH
Contact information
Practice address
600 SHELDON ST, CRESTON, IA 50801-3322
(641) 782-8417
(641) 782-6858
Mailing address
600 SHELDON ST, CRESTON, IA 50801-3322
(641) 782-8417
(641) 782-6858
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
11257
CO
183500000X
Pharmacist
16443
IA
Other
Enumeration date
12/27/2012
Last updated
12/27/2012
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