Individual
DR. DAVID B JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4410 WATERMELON RD, NORTHPORT, AL 35473-5204
(205) 345-1520
(205) 345-1761
Mailing address
4410 WATERMELON RD, NORTHPORT, AL 35473-5204
(205) 345-1520
(205) 345-1761
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
00018093
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000022709
—
AL
01
—
051022709
BCBS
AL
Enumeration date
06/08/2006
Last updated
12/23/2010
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