Individual
REBECCA JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
834 CHESTNUT ST, SUITE 420, PHILADELPHIA, PA 19107-5127
(215) 955-6776
(215) 955-4020
Mailing address
834 CHESTNUT ST, SUITE 420, PHILADELPHIA, PA 19107-5127
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
MD422220
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0004588
—
NJ
05
—
001960192
—
PA
Enumeration date
04/26/2006
Last updated
11/18/2013
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