Individual
DR. STEPHEN JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1170 CLEVELAND AVE, EAST POINT, GA 30344-3615
(404) 466-1600
Mailing address
1170 CLEVELAND AVE, EAST POINT, GA 30344-3615
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
217666
NC
207P00000X
Emergency Medicine Physician
Primary
82539
GA
Other
Enumeration date
03/22/2016
Last updated
08/19/2019
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