Individual
MRS. TINA LOUISE JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
224 OLD MILL RD, WARTBURG, TN 37887-4163
(423) 346-6221
(423) 346-3447
Mailing address
240 W TYRONE RD RM 714, OAK RIDGE, TN 37830-6517
(865) 482-1076
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
61207
TN
Other
Enumeration date
04/25/2007
Last updated
05/14/2021
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