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Individual

ANNIE M JACKSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
153 W COURT ST, RUTHERFORDTON, NC 28139-2804
(828) 288-0880
Mailing address
PO BOX 591, RUTHERFORDTON, NC 28139-0591
(828) 288-0880

Taxonomy

Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
98-00575
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
891139E
NC
Enumeration date
02/16/2007
Last updated
10/02/2013
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