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Individual

CARSWELL HOOTS JACKSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
2102 N ELM ST STE H1, GREENSBORO, NC 27408-5100
(336) 808-5135
(336) 808-5388
Mailing address
3625 N ELM ST, SUITE 110A, GREENSBORO, NC 27455-2604
(336) 282-4840
(336) 282-4660

Taxonomy

Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
38781
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
010102405
VA
01
45521
BCBS
NC
05
8945521
NC
Enumeration date
05/17/2006
Last updated
08/22/2024
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