Individual
LAUREN HOLT JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
2507 BROADWAY ST, PADUCAH, KY 42001-3124
(270) 442-8228
Mailing address
1900 N FRIENDSHIP RD, PADUCAH, KY 42001-8690
(901) 485-2032
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
46159
KY
Other
Enumeration date
04/10/2009
Last updated
07/30/2014
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