Individual
SAMUEL HOWARD JACKSON JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNP-FNP-C
Contact information
Practice address
6074 LAKESIDE DR, PINSON, AL 35126-2300
(205) 243-4751
Mailing address
2820 CRESTWOOD BLVD, IRONDALE, AL 35210-1229
(205) 838-6775
Taxonomy
Speciality
Code
Description
License number
State
111NX0100X
Occupational Health Chiropractor
Primary
111NX0100X
AL
Other
Enumeration date
05/09/2023
Last updated
05/09/2023
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