Individual
PATRICK JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1000 BLYTHE BLVD, CHARLOTTE, NC 28203-5812
(704) 355-2171
Mailing address
1000 BLYTHE BLVD, CHARLOTTE, NC 28203-5812
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
2016-00882
NC
207P00000X
Emergency Medicine Physician
39300
SC
Other
Enumeration date
05/16/2013
Last updated
01/21/2021
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