Individual
DR. ERIC A JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
811 SIXTH STREET, SUITE #210, WICHITA FALLS, TX 76301
(940) 761-6004
Mailing address
811 SIXTH STREET, SUITE #210, WICHITA FALLS, TX 76301
(940) 761-6004
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
DO TRAINING CERT.
OH
207P00000X
Emergency Medicine Physician
TPA00011
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
192110801
—
MS
Enumeration date
10/25/2006
Last updated
06/02/2018
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