Individual
KECIA STRAWTER JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
8011 MALL PARKWAY, KAISER PERMANENTE STONECREST MEDICAL CENTER, LITHONIA, GA 30038
(678) 323-7521
(770) 761-6626
Mailing address
3495 PIEDMONT ROAD, NE, NINE PIEDMONT CENTER, ATLANTA, GA 30305
(404) 364-7070
(770) 761-6626
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
038978
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00617328I
—
GA
Enumeration date
05/17/2006
Last updated
12/12/2012
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