Individual
MR. JERRY W JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
817 PRINCETON AVE SW, SUITE 210, BIRMINGHAM, AL 35211
(205) 226-5911
(205) 226-5939
Mailing address
817 PRINCETON AVE SW, SUITE 210, BIRMINGHAM, AL 35211
(205) 226-5911
(205) 226-5939
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
6279
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000003165
—
AL
Enumeration date
05/05/2006
Last updated
01/12/2011
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