Organization
JABEZ F. JACKSON, JR., M.D., PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JABEZ F JACKSON JR. M.D. (PRESIDENT)
(870) 523-3289
Entity
Organization
Contact information
Practice address
1201 MCLAIN ST, NEWPORT, AR 72112-3533
(870) 523-3289
(870) 523-4846
Mailing address
PO BOX 1210, NEWPORT, AR 72112-1210
(870) 523-3289
(870) 523-4846
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
C-4208
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
126751002
—
AR
Enumeration date
08/05/2006
Last updated
05/16/2011
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