Individual
WILLIAM L JACKSON JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
6151 S YALE AVE, SUITE 2402, TULSA, OK 74136-1907
(918) 481-4600
Mailing address
6151 S YALE AVE, SUITE 2402, TULSA, OK 74136-1907
(918) 481-4600
Taxonomy
Speciality
Code
Description
License number
State
2080P0202X
Pediatric Cardiology Physician
Primary
10597
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100100470A
—
OK
Enumeration date
04/05/2006
Last updated
08/22/2010
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