Individual
ALAN DAVID JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
4000 KRESGE WAY, LOUISVILLE, KY 40207-4605
(502) 895-8911
Mailing address
3950 KRESGE WAY, STE 308, LOUISVILLE, KY 40207-4637
(502) 895-8911
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
47185
KY
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/12/2011
Last updated
10/15/2014
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