Individual
DR. DAVID WAYNE JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
5300 HARROUN RD, SUITE 201, SYLVANIA, OH 43560-2182
(419) 843-4836
(419) 841-8458
Mailing address
5300 HARROUN RD, SUITE 201, SYLVANIA, OH 43560-2182
(419) 843-4836
(419) 841-8458
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
34-005219
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0837063
—
OH
Enumeration date
07/27/2006
Last updated
09/10/2013
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