Individual
EDWARD JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
AA
Contact information
Practice address
550 PEACHTREE ST NE, ATLANTA, GA 30308-2212
(404) 686-4411
Mailing address
550 PEACHTREE ST NE, ATLANTA, GA 30308-2212
(404) 686-4411
Taxonomy
Speciality
Code
Description
License number
State
367H00000X
Anesthesiologist Assistant
Primary
10437
GA
Other
Enumeration date
06/04/2021
Last updated
10/11/2022
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