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Organization

F. DANIEL JACKSON, MD, PA

Active
Other names
The Imaging Center
Organization subpart
No

Provider details

NPI number
Authorized official
DR. F. DANIEL JACKSON MD, PA (PRESIDENT/OWNER)
(301) 759-3410
Entity
Organization

Contact information

Practice address
715 WILLIAMS STREET, CUMBERLAND, MD 21502
(301) 759-3410
(301) 759-3522
Mailing address
PO BOX 1692, CUMBERLAND, MD 21501-1692
(301) 759-3817
(301) 759-3043

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
261QR0200X
Radiology Clinic/Center
Primary
D0020433
MD
261QR0200X
Radiology Clinic/Center

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
305591400
MD
05
440082800
MD
Enumeration date
07/23/2007
Last updated
05/17/2011
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