Individual
DR. OSCAR D. JACKSON JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
805 S HANSELL ST, THOMASVILLE, GA 31792-5560
(229) 225-1357
Mailing address
805 S HANSELL ST, THOMASVILLE, GA 31792-5560
(229) 225-1357
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
030793
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00372523D
—
GA
05
—
00372523E
—
GA
Enumeration date
01/10/2006
Last updated
06/14/2010
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