Individual
DR. BENITA MARIE JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
7252 TUMBLEBROOK DR, NEW ALBANY, OH 43054-8891
(614) 933-0095
Mailing address
7252 TUMBLEBROOK DR, NEW ALBANY, OH 43054-8891
(614) 933-0095
Taxonomy
Speciality
Code
Description
License number
State
2083P0901X
Public Health & General Preventive Medicine Physician
Primary
35-061647
OH
Other
Enumeration date
01/02/2007
Last updated
07/08/2007
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