Individual
PATRICK JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3800 RESERVOIR RD NW, WASHINGTON, DC 20007-2113
(202) 444-7252
Mailing address
PO BOX 418283, BOSTON, MA 02241-8283
(703) 558-1544
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
34241
DC
Other
Enumeration date
07/19/2005
Last updated
03/08/2012
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