Individual
WILLIAM LEMAR JACKSON JR.
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1350 S HICKORY ST, MELBOURNE, FL 32901-3278
(321) 434-4225
(321) 434-4247
Mailing address
PO BOX 561600, ROCKLEDGE, FL 32956-1600
(321) 434-4656
(321) 259-5130
Taxonomy
Speciality
Code
Description
License number
State
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
Primary
ME95860
FL
Other
Enumeration date
05/18/2006
Last updated
07/08/2007
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