Individual
PAUL EDWARD JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
272 HOSPITAL RD, CHILLICOTHE, OH 45601-9031
(740) 779-8575
(740) 779-8579
Mailing address
272 HOSPITAL RD, SUITE 3, CHILLICOTHE, OH 45601-9031
(740) 779-8234
(740) 779-7477
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
35.086453
OH
207R00000X
Internal Medicine Physician
TEMPORARY
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2813432
—
OH
Enumeration date
06/02/2006
Last updated
11/21/2008
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