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Organization

JACKSON FAMILY MEDICINE, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. DAINTY J JACKSON DO.,MPA.,MT.,ASCP. (DOCTOR)
(301) 885-3350
Entity
Organization

Contact information

Practice address
10 SAINT PATRICKS DR, #502, WALDORF, MD 20603-4527
(301) 885-3350
(301) 885-0061
Mailing address
PO BOX 7876, UPPER MARLBORO, MD 20792-7876
(301) 885-3350
(301) 885-0061

Taxonomy

Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
H0058218
MD

Other

Enumeration date
03/12/2009
Last updated
03/12/2009
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