Individual
DR. GALE EVANS JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
490 DUNLOP LN, CLARKSVILLE, TN 37040-5007
(931) 245-8600
(931) 245-8660
Mailing address
PO BOX 3799, CLARKSVILLE, TN 37043-3799
(931) 245-7000
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
0101244386
VA
207Q00000X
Family Medicine Physician
0116019100
VA
207Q00000X
Family Medicine Physician
Primary
48690
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
Q000101
—
TN
Enumeration date
07/30/2008
Last updated
08/29/2022
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