Individual
MICHELLE S. JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
2423 SCHILLINGER RD S, MOBILE, AL 36695-4136
(251) 605-9506
(251) 660-5949
Mailing address
6701 AIRPORT BLVD, STE A101, MOBILE, AL 36608-6767
(251) 378-6209
(251) 378-6222
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
00018274
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
051553281
—
AL
Enumeration date
08/01/2006
Last updated
01/02/2019
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