Individual
JAMES C JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
3719 DAUPHIN ST, SPRINGHILL MED CTR ANESTHESIA DEPT, MOBILE, AL 36608-1753
(251) 342-3000
(251) 342-3043
Mailing address
PO BOX 851417, MOBILE, AL 36685-1417
(251) 342-3000
(251) 342-3043
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
1020688
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000022017
MEDICARE TRAVELERS PIN
AL
05
—
000022017
—
AL
05
—
105361
—
AL
01
—
CN0216
MEDICARE TRAVELERS
AL
Enumeration date
02/14/2006
Last updated
01/30/2009
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