Organization
RONNIE L. JACKSON MD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RONNIE LEE JACKSON M.D. (OWNER)
(615) 382-1037
Entity
Organization
Contact information
Practice address
496 NORTHCREST DR, SPRINGFIELD, TN 37172-3972
(615) 382-1037
(615) 382-0990
Mailing address
496 NORTHCREST DR, SPRINGFIELD, TN 37172-3972
(615) 382-1037
(615) 382-0990
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
MD020868
TN
Other
Enumeration date
08/29/2014
Last updated
08/29/2014
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