Individual
ANNA LOYAL JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
2100 CENTRAL AVE STE D1, AUGUSTA, GA 30904-6709
(912) 216-2278
Mailing address
2801 WASHINGTON RD STE 107 #275, AUGUSTA, GA 30909
(912) 216-2278
Taxonomy
Speciality
Code
Description
License number
State
2084F0202X
Forensic Psychiatry Physician
Primary
82106
GA
Other
Enumeration date
04/20/2015
Last updated
07/24/2024
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