Individual
DR. AMANDA TUCKER JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
700 S PARK ST, MADISON, WI 53715-1830
(608) 258-6800
Mailing address
371 MEDINAH ST, OREGON, WI 53575-3839
(608) 291-2140
(608) 291-2140
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
50472-20
WI
Other
Enumeration date
07/20/2006
Last updated
08/18/2011
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