Individual
PAMELA E JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
4001 COLISEUM DR STE 300, HAMPTON, VA 23666-6257
(757) 827-2025
(757) 275-9802
Mailing address
4001 COLISEUM DR STE 300, HAMPTON, VA 23666-6257
(757) 827-2025
(757) 275-9802
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
0101271362
VA
207R00000X
Internal Medicine Physician
035139
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
004235736
COMMUNITY HEALTH NETWORK
—
05
—
004235736
—
CT
01
—
010035139CT03
ANTHEM BLUE CROSS BLUE SH
—
01
—
035139
CT CARE
—
01
—
10Q3466
HEALTHNET
—
01
—
3171723
AETNA
—
01
—
P3597371
OXFORD
—
Enumeration date
09/11/2006
Last updated
12/06/2023
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