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Organization

ALAN F JACKS, MD PA

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. ALAN F. JACKS M.D. (PRESIDENT)
(828) 874-0555
Entity
Organization

Contact information

Practice address
845 MALCOLM BLVD, RUTHERFORD COLLEGE, NC 28671-0476
(828) 874-0555
(828) 874-2111
Mailing address
PO BOX 476, RUTHERFORD COLLEGE, NC 28671-0476
(828) 874-0555
(828) 874-2111

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
96-01640
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1013E
BCBS
NC
05
5909135
NC
05
891013E
NC
01
96-01640
NC LICENSE
NC
Enumeration date
07/20/2005
Last updated
09/08/2011
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