Individual
RONALD L JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
5400 S COBB DR SE, SMYRNA, GA 30080-7421
(404) 794-7390
Mailing address
1020 NEW HOPE RD SW, ATLANTA, GA 30331-7238
(404) 691-3374
(404) 505-1985
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
034860
GA
Other
Enumeration date
05/04/2007
Last updated
07/08/2007
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