Individual
DR. ALAN FOWLER JACKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M. D.
Contact information
Practice address
845 MALCOLM BLVD., CONNELLY SPRINGS, NC 28612
(828) 580-3555
(828) 874-2111
Mailing address
845 MALCOLM BLVD., CONNELLY SPRINGS, NC 28612
(828) 580-3555
(828) 874-2111
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
9601640
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1992987713
—
NC
05
—
891013E
—
NC
Enumeration date
12/04/2007
Last updated
05/23/2018
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