Individual
DR. JAMES BRIAN JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.M.D.
Contact information
Practice address
811 S 28TH AVE, HATTIESBURG, MS 39402-2602
(601) 261-2611
Mailing address
811 S 28TH AVE, HATTIESBURG, MS 39402-2602
(601) 261-2611
(601) 984-4949
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
3742-14
MS
1223G0001X
General Practice Dentistry
3742-14
MS
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
3742-14
MS
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
05/15/2014
Last updated
02/23/2021
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