Organization
W JACKSON ILIFF M.D., LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
W JACKSON ILIFF M.D. (OWNER)
(410) 869-1990
Entity
Organization
Contact information
Practice address
4 W ROLLING CROSSROADS, STE 7, CATONSVILLE, MD 21228-6280
(410) 869-1990
Mailing address
4 W ROLLING CROSSROADS, STE 7, CATONSVILLE, MD 21228-6280
(410) 869-1990
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
D08485
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
964451200
—
MD
Enumeration date
11/12/2009
Last updated
11/12/2009
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