Individual
RUBIE SUE JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
2000 MEDICAL PARKWAY, SUITE 200, ANNAPOLIS, MD 21401
(443) 481-5300
(443) 481-6705
Mailing address
PO BOX 12622, BELFAST, ME 04915
(443) 481-6573
(443) 481-6515
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
D77385
MD
390200000X
Student in an Organized Health Care Education/Training Program
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—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
213518300
—
MD
Enumeration date
03/10/2009
Last updated
02/05/2015
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