Individual
DR. IRA MICHAEL JACKLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
3550 UNIVERSITY BLVD S, SUITE 207, JACKSONVILLE, FL 32216-4246
(904) 739-6666
(904) 739-1009
Mailing address
PO BOX 56917, JACKSONVILLE, FL 32241-6917
(904) 739-6666
(904) 739-1009
Taxonomy
Speciality
Code
Description
License number
State
207RP1001X
Pulmonary Disease Physician
Primary
ME0022114
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
15314
BCBSFL
FL
Enumeration date
07/11/2006
Last updated
07/08/2007
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