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Individual

DAVID M JACKSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1980 TAMARACK RD, NEWARK, OH 43055-1363
(740) 788-9220
(740) 788-9226
Mailing address
1980 TAMARACK RD, NEWARK, OH 43055-1363
(740) 788-9220
(740) 788-9226

Taxonomy

Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
35407273
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0607776
OH
Enumeration date
07/21/2006
Last updated
07/08/2007
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