Individual
DR. TAD JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3125A ELUA ST, LIHUE, HI 96766-1212
(808) 245-5383
Mailing address
PO BOX 3070, LIHUE, HI 96766-6070
(808) 245-5383
(808) 245-5380
Taxonomy
Speciality
Code
Description
License number
State
207RP1001X
Pulmonary Disease Physician
Primary
10307
HI
Other
Enumeration date
03/01/2006
Last updated
07/08/2007
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