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Individual

EARL F JACKMAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.O.

Contact information

Practice address
222 OAK AVE, TOMS RIVER, NJ 08753-3348
(732) 914-1919
(732) 341-3303
Mailing address
222 OAK AVE, TOMS RIVER, NJ 08753-3348
(732) 914-1919
(732) 341-3303

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
25MB04461200
NJ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
010045046NJ01
ST BARNABAS HEALTH
NJ
01
0159635000
AMERIHEALTH NJ
NJ
05
0176109
NJ
01
429240
AMERIHEALTH ADMIN
NJ
01
5944918
CIGNA COMED
NJ
01
5944918004
CIGNA HMO
NJ
01
F02902
HEALTH NET PHS
NJ
01
VP016
OXFORD
NJ
Enumeration date
06/19/2006
Last updated
07/08/2007
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