Individual
LAWRENCE JACKMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
222 TONGASS DR, SITKA, AK 99835-9416
(907) 966-2411
Mailing address
222 TONGASS DR, SITKA, AK 99835-9416
(907) 966-2411
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
4688
AK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
MD7730
—
AK
Enumeration date
09/20/2006
Last updated
10/22/2007
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