Individual
GEORGE WOODY JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1440 HIGHWAY 62 412, HIGHLAND, AR 72542-9497
(870) 856-6000
(870) 856-6001
Mailing address
1440 HIGHWAY 62 412, HIGHLAND, AR 72542-9497
(870) 856-6000
(870) 856-6001
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
N7190
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
112923001
—
AR
Enumeration date
11/06/2006
Last updated
04/27/2009
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