Individual
JEFFREY A JACKMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4825 MARK CENTER DR STE 150, ALEXANDRIA, VA 22311-1846
(703) 751-8111
(703) 751-1105
Mailing address
2901 TELESTAR CT STE 300, FALLS CHURCH, VA 22042-1263
(703) 591-1688
(703) 591-1445
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
0101058984
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
037480600
—
DC
05
—
1437111622
—
VA
05
—
409325900
—
MD
01
—
P00302186
RAILROAD MEDICARE DC #
DC
Enumeration date
04/04/2006
Last updated
08/25/2022
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