Organization
MELINDA JACKSON MD PHD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MELINDA BROWN JACKSON MD,PHD (OWNER/PHYSICIAN)
(812) 858-1957
Entity
Organization
Contact information
Practice address
4144 WYNTREE DR, NEWBURGH, IN 47630-2521
(812) 858-1957
(812) 858-1917
Mailing address
4144 WYNTREE DR, NEWBURGH, IN 47630-2521
(812) 858-1957
(812) 858-1917
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
01037696A
IN
363L00000X
Nurse Practitioner
71002200A
IN
Other
Enumeration date
02/01/2008
Last updated
02/01/2008
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