Individual
DR. TODD LINCOLN JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
710 EASTERN ST STE H, KINGMAN, AZ 86401-5486
(928) 224-0536
Mailing address
710 EASTERN ST STE H, KINGMAN, AZ 86401-5486
(928) 224-0536
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
52840
AZ
Other
Enumeration date
10/02/2007
Last updated
11/10/2022
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