Individual
DR. MELINDA BROWN JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D., PHD
Contact information
Practice address
4144 WYNTREE DR, NEWBURGH, IN 47630-2521
(812) 858-1957
(812) 858-1917
Mailing address
4144 WYNTREE DR, NEWBURGH, IN 47630-2521
(812) 858-1957
(812) 858-1917
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
01037696
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100180410
—
IN
Enumeration date
01/27/2006
Last updated
01/23/2014
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