Individual
DR. RODNEY MARK JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD,FAAP
Contact information
Practice address
3654 W ANTHEM WAY, SUITE B-114, ANTHEM, AZ 85086-0455
(623) 551-0442
(623) 551-7389
Mailing address
3654 W ANTHEM WAY, SUITE B-114, ANTHEM, AZ 85086-0455
(623) 551-0442
(623) 551-7389
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
28940
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
576077
—
AZ
Enumeration date
07/07/2005
Last updated
07/09/2007
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