Individual
DR. DAVID BRADLEY JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
MSC INTERNAL MEDICINE 1 UNIVERSITY OF NEW MEXICO, ALBUQUERQUE, NM 87131-0001
(505) 272-4661
Mailing address
PO BOX 27128, SALT LAKE CITY, UT 84127-0128
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
DO2023-1106
NM
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
Primary
8269149-1204
UT
208M00000X
Hospitalist Physician
DO2023-1106
NM
390200000X
Student in an Organized Health Care Education/Training Program
—
NM
Other
Enumeration date
04/02/2020
Last updated
05/14/2026
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