Individual
AURELIA J JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
700 CHILDRENS DR, COLUMBUS, OH 43205-2664
(614) 722-4950
(614) 722-4966
Mailing address
700 CHILDRENS DR, COLUMBUS, OH 43205-2664
(614) 722-2000
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
35072952
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2084579
—
OH
01
—
4109921
CGS - MEDICARE
OH
Enumeration date
01/10/2006
Last updated
03/16/2022
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