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Individual

STEPHEN T JACKSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1613 N MCKENZIE ST, FOLEY, AL 36535-2247
(251) 949-3710
(251) 949-3715
Mailing address
1613 N MCKENZIE ST, FOLEY, AL 36535-2247
(251) 949-3710
(251) 949-3715

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
00015458
AL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
04685310
MS
05
235881
AL
Enumeration date
07/28/2006
Last updated
10/14/2025
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