Individual
SHA-RON JACKSON-JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
101 E 87TH AVE, SUITE 420, MERRILLVILLE, IN 46410-7335
(219) 769-2041
(219) 769-2313
Mailing address
7895 GRAND BLVD, HOBART, IN 46342-6665
(219) 947-1910
(219) 947-3117
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
01076732A
IN
208600000X
Surgery Physician
57010730
OH
2086S0127X
Trauma Surgery Physician
35 123453
OH
Other
Enumeration date
05/25/2007
Last updated
09/13/2016
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