Individual
JON C JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2500 NORTH STATE STREET, JACKSON, MS 39216
(601) 984-6441
(601) 815-6446
Mailing address
2500 NORTH STATE STREET, JACKSON, MS 39225
(601) 925-6805
(601) 815-6446
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
21288
MS
2084P0800X
Psychiatry Physician
T1958
MS
Other
Enumeration date
01/26/2008
Last updated
02/05/2014
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