Individual
DR. JEREMY JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O., M.P.H.
Contact information
Practice address
405 W GRAND AVE, DAYTON, OH 45405-4720
(937) 723-3567
(937) 723-5017
Mailing address
1391 FINGER LKS, DAYTON, OH 45458-3121
(740) 505-3022
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
011603
OH
207P00000X
Emergency Medicine Physician
02005405A
IN
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
06/07/2013
Last updated
10/06/2022
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