Individual
JAMES BRANTLEY JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
3651 WHEELER RD, AUGUSTA, GA 30909-6521
(706) 855-9860
(706) 860-7124
Mailing address
PO BOX 204097, AUGUSTA, GA 30917-4097
(706) 855-9860
(706) 860-7124
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
160976
GA
Other
Enumeration date
01/26/2010
Last updated
02/06/2020
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