Individual
JERRY JAY JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3134 NORTHSIDE DR, BLDG B, KEY WEST, FL 33040-8004
(305) 809-5278
Mailing address
3134 NORTHSIDE DR, BLDG B, KEY WEST, FL 33040-8004
(305) 809-5278
Taxonomy
Speciality
Code
Description
License number
State
207RI0200X
Infectious Disease Physician
64653
GA
207RI0200X
Infectious Disease Physician
Primary
ME114239
FL
Other
Enumeration date
11/09/2007
Last updated
10/16/2013
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