Individual
DR. MICHAEL JOSEPH JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
5311 PAULSEN ST, SAVANNAH, GA 31405-4800
(912) 355-1111
(912) 352-7136
Mailing address
5311 PAULSEN ST, SAVANNAH, GA 31405-4800
(912) 355-1111
(912) 352-7136
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
038019
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00729473A
—
GA
01
—
038019
LICENSE #
GA
Enumeration date
11/06/2006
Last updated
03/07/2023
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