Individual
MR. CEDERIC PHILLAUDER JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RN MSN
Contact information
Practice address
99 JESSIE HILL JR DRIVE, ATL, GA 30303
(404) 730-1418
(404) 730-1499
Mailing address
99 JESSE HILL JR DRIVE SE, ROOM 402, ATLANTA, GA 30303
(404) 730-1418
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
RN066374
GA
Other
Enumeration date
11/15/2006
Last updated
07/08/2007
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