Individual
DR. MARK JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
10 STANDING ROCK AGENCY AVENUE, FORT YATES, ND 58538
(701) 854-3831
(701) 854-7411
Mailing address
10 RIVER ROAD, FORT YATES, ND 58538-0179
(701) 854-3831
(701) 854-7411
Taxonomy
Speciality
Code
Description
License number
State
2083P0901X
Public Health & General Preventive Medicine Physician
Primary
012211
ME
Other
Enumeration date
05/02/2007
Last updated
06/27/2008
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