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Individual

ROBERT JACKSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
800 S BROWN ST, SPRINGFIELD, TN 37172-2920
(615) 384-4504
Mailing address
5005 INDIAN RIDGE BLVD, WHITE HOUSE, TN 37188-4334
(615) 384-4504

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
114725
TN

Other

Enumeration date
11/13/2025
Last updated
11/13/2025
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