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Individual

BURKE L JACKSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
1808 E SILVER SPRINGS BLVD, OCALA, FL 34470-6921
(352) 291-5000
(352) 291-5004
Mailing address
1808 E SILVER SPRINGS BLVD, OCALA, FL 34470-6921
(352) 291-5000
(352) 291-5004

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
ME38870
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
041557001
FL
01
94201
BLUE CROSS BLUE SHIELD OF FLORIDA
FL
Enumeration date
06/07/2006
Last updated
02/15/2016
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