Individual
JORDAN TYLER JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1100 HIGHWAY 16 E, CARTHAGE, MS 39051-4222
(601) 267-1470
(601) 267-1469
Mailing address
965 RIDGE LAKE BLVD STE 315, MEMPHIS, TN 38120-9401
(877) 348-1281
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
33753
MS
Other
Enumeration date
05/04/2021
Last updated
07/25/2024
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