Individual
DR. GARLAND CONWAY JACKSON JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
33-57 HARRISON ST, JOHNSON CITY, NY 13790-2107
(607) 763-6412
(607) 763-5854
Mailing address
33 LEWIS RD, BINGHAMTON, NY 13905-1048
(607) 770-0025
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
243575
NY
207R00000X
Internal Medicine Physician
243575
NY
Other
Enumeration date
03/27/2006
Last updated
09/03/2020
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