Individual
DR. ALEX MITCHELL JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
2699 TOWNSEND CT, CLARKSVILLE, TN 37043-6487
(931) 647-8417
(931) 648-4435
Mailing address
2699 TOWNSEND CT, CLARKSVILLE, TN 37043-6487
(931) 647-8417
(931) 648-4435
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
3379
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
Q009057
—
TN
Enumeration date
07/17/2017
Last updated
02/11/2020
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