Individual
DR. MARVIN WILLIAM JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD, MS
Taxonomy
Speciality
Code
Description
License number
State
2083A0100X
Aerospace Medicine Physician
Primary
036.122582
IL
2083A0100X
Aerospace Medicine Physician
35.085150
OH
Other
Enumeration date
08/08/2013
Last updated
08/08/2013
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