Individual
MARKUS JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
4016 DALE RD, MODESTO, CA 95356-9268
(209) 571-0288
(209) 571-0327
Mailing address
PO BOX 27345, BELFAST, ME 04915-2025
(209) 571-0288
(209) 571-0327
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
A165519
CA
208VP0000X
Pain Medicine Physician
A165519
CA
208VP0014X
Interventional Pain Medicine Physician
Primary
A165519
CA
Other
Enumeration date
04/13/2015
Last updated
06/17/2025
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