Individual
DR. JACKSON B TAYLOR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
200 MERCY CIRCLE, CAMP PENDLETON, CA 92055-5191
(760) 719-3696
Mailing address
4398 STANFORD ST, CARLSBAD, CA 92010-7922
(757) 469-5474
Taxonomy
Speciality
Code
Description
License number
State
208200000X
Plastic Surgery Physician
9901339
NC
2086S0122X
Plastic and Reconstructive Surgery Physician
Primary
9901339
NC
Other
Enumeration date
05/08/2008
Last updated
04/27/2022
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