Individual
DR. JEFFREY BURKE JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
100 SENECA RD, ELKINS, WV 26241-9709
(304) 637-2777
(304) 636-8825
Mailing address
125 N 6TH ST, CLARKSBURG, WV 26301-2665
(304) 624-7200
(304) 636-8825
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
16375
WV
207ND0900X
Dermatopathology Physician
Primary
16375
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0074811000
—
WV
Enumeration date
06/27/2006
Last updated
01/23/2015
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