Organization
G HAGAN JACKSON MD PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GEORGE HAGAN JACKSON MD (OWNER/PROVIDER)
(804) 588-6993
Entity
Organization
Contact information
Practice address
5231 HICKORY PARK DR, SUITE D, GLEN ALLEN, VA 23059-2619
(804) 588-6993
Mailing address
PO BOX 4319, GLEN ALLEN, VA 23058-4319
(804) 588-6993
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
0101238219
VA
Other
Enumeration date
11/05/2013
Last updated
11/05/2013
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