Organization
DR. GEORGE W. JACKSON PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CARY JACKSON (BUSINESS MANAGER)
(870) 856-6000
Entity
Organization
Contact information
Practice address
1440 HIGHWAY 62 412, HIGHLAND, AR 72542-9497
(870) 856-6000
(870) 856-6001
Mailing address
1440 HIGHWAY 62 412, HIGHLAND, AR 72542-9497
(870) 856-6000
(870) 856-6001
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
MC1251
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
142802002
—
AR
Enumeration date
04/16/2007
Last updated
04/27/2009
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