Individual
DR. JONATHAN JUTURU JACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
270 SMITH CHURCH ROAD, ROANOKE RAPIDS, NC 27870
(252) 537-0134
(252) 537-6515
Mailing address
PO BOX 640, ROANOKE RAPIDS, NC 27870-0640
(252) 536-5440
(252) 536-5444
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
9701417
NC
Other
Enumeration date
11/13/2006
Last updated
07/13/2021
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