Individual
OKSANA JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
34TH & CIVIC CENTER BLVD, CHILDRENS HOSPITAL OF PHILADELPHIA, PHILADELPHIA, PA 19104-4306
(215) 590-2208
(215) 590-2496
Mailing address
100 EAST PENN SQUARE, THE WANAMAKER BUILDING 9TH FL, PHILADELPHIA, PA 19107-3323
(267) 425-9538
(267) 425-9552
Taxonomy
Speciality
Code
Description
License number
State
208200000X
Plastic Surgery Physician
Primary
MD424308
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
102095848-0001
—
PA
Enumeration date
12/28/2006
Last updated
04/11/2013
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