Organization
JACKSON FAMILY PRACTICE, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
STANLEY R ANDERSON M.D. (PRESIDENT)
(330) 966-1319
Entity
Organization
Contact information
Practice address
7072 MEARS GATE DR. NW, NORTH CANTON, OH 44720-8850
(330) 966-1319
(330) 966-1321
Mailing address
7072 MEARS GATE DR. NW, NORTH CANTON, OH 44720-8850
(330) 966-1319
(330) 966-1321
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
35055884
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0684344
—
OH
05
—
2206713
—
OH
Enumeration date
08/22/2006
Last updated
11/21/2012
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