Individual
DR. JABEZ FENTON JACKSON JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1201 MCLAIN ST, NEWPORT, AR 72112-3533
(870) 523-3289
(870) 523-4846
Mailing address
PO BOX 1210, NEWPORT, AR 72112-1210
(870) 523-5713
(870) 523-4846
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
C4208
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
102814001
—
AR
Enumeration date
01/23/2006
Last updated
05/16/2011
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