Individual
MARK JACKMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
215 PERRY HILL RD, MONTGOMERY, AL 36109-3725
(180) 145-5538
Mailing address
8730 RIDGESTONE CT, MONTGOMERY, AL 36117-8875
(801) 455-5383
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
POD001488
GA
Other
Enumeration date
06/27/2018
Last updated
04/04/2022
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