Individual
MICHAEL L JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
2626 CAPITAL MEDICAL BLVD, EMERGENCY MEDICINE, TALLAHASSEE, FL 32308-4402
(580) 325-5000
Mailing address
2626 CAPITAL MEDICAL BLVD, TALLAHASSEE, FL 32308-4402
(850) 325-5000
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
0102202687
VA
207P00000X
Emergency Medicine Physician
4229
TN
207P00000X
Emergency Medicine Physician
Primary
OS21831
FL
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
08/15/2009
Last updated
04/22/2025
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