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Individual

ALOYSIUS JACKSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
301 TURNER MCCALL BLVD, ROME, GA 30165
(706) 509-4340
(706) 291-2147
Mailing address
304 TURNER MCCALL BLVD SW, ROME, GA 30165-5621
(770) 324-5131

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
134079
IL
207Q00000X
Family Medicine Physician
2018004381
MO
207Q00000X
Family Medicine Physician
37435
SC
207Q00000X
Family Medicine Physician
77026
GA
207Q00000X
Family Medicine Physician
Q0769
TX
208M00000X
Hospitalist Physician
Primary
77026
GA

Other

Enumeration date
12/08/2011
Last updated
12/28/2020
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