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Organization

RICHARD T JACKSON LLC

Active
Parent organization
RICHARD T JACKSON LLC
Other names
Saratoga Neurology Specialists
Organization subpart
Yes

Provider details

NPI number
Legal business name
RICHARD T JACKSON LLC
Authorized official
RICHARD T JACKSON MD (OWNER)
(646) 957-7648
Entity
Organization

Contact information

Practice address
3 LEAR JET LN STE 203, LATHAM, NY 12110-2322
(518) 258-4033
Mailing address
7 SOUTHSIDE DR STE 206, CLIFTON PARK, NY 12065-3894
(518) 709-0005

Taxonomy

Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary

Other

Enumeration date
08/04/2020
Last updated
08/04/2020
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