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Individual

DR. CARL E. JACKSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
386 MEDWAY RD, HIGHLAND HEIGHTS, OH 44143-3734
(440) 953-1898
(440) 460-0749
Mailing address
386 MEDWAY RD, HIGHLAND HEIGHTS, OH 44143-3734
(440) 953-1898
(440) 460-0749

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
35057489
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0881247
OH
Enumeration date
08/30/2006
Last updated
05/02/2017
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