Individual
MICKEY JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
610 JOHN ROBINSON TL., DUBLIN, GA 31021
(478) 484-9627
(478) 272-4081
Mailing address
610 JOHN ROBINSON TRL, DUBLIN, GA 31021-2011
(478) 484-9627
(478) 272-4081
Taxonomy
Speciality
Code
Description
License number
State
343900000X
Non-emergency Medical Transport (VAN)
Primary
—
—
Other
Enumeration date
09/16/2015
Last updated
09/16/2015
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