Individual
CAROLINE N JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
231 E CHESTNUT ST, LOUISVILLE, KY 40202-1821
(502) 588-0982
(502) 588-0987
Mailing address
PO BOX 776879, CHICAGO, IL 60677-6879
(502) 588-9490
(502) 272-5116
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
56401
KY
2080N0001X
Neonatal-Perinatal Medicine Physician
56401
KY
390200000X
Student in an Organized Health Care Education/Training Program
—
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7100676360
—
KY
Enumeration date
03/31/2019
Last updated
01/08/2026
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