Individual
DR. KIMBERLY L JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
818 ELLICOTT ST, BUFFALO, NY 14203-1021
(716) 323-2000
(716) 323-0292
Mailing address
1001 MAIN ST FL 5, BUFFALO, NY 14203-1009
(716) 323-0034
(716) 323-0292
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
248351
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03040719
—
NY
Enumeration date
06/26/2008
Last updated
03/02/2023
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