Mark K Jackson M.D.

NPI 1063405538 - Radiology - 2085R0202X

NPI Details
NPI 1063405538
Gender Male
Enumeration Date 08/30/2005
Last Updated 09/13/2007
Entity Type Individual
Active Over 12 years ago
Practice Location
110 W 6TH ST
OSWEGO NY, 13126-2507, US
Phone (315) 349-5000
Business Location
OSWEGO NY, 13126-3031, US
Phone (315) 343-0257
Fax (315) 343-0948
Taxonomy Code 2085R0202X
License State New York
License Number 196101
Remove 1063405538 NPI Number

According to our database, Dr. Mark K Jackson M.D. NPI is 1063405538, taxonomy code is 2085R0202X and license number is 196101, license state is located at New York. Mark K Jackson M.D. physically located at 110 W 6th St, Oswego NY, 13126-2507. NPI Number Mark K Jackson M.D. has the Individual type.

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1063405538 NPI number is provided on an as is basis without warranty of any kind. 1063405538 is maintained by the National Plan & Provider Enumeration System. The contents of Mark K Jackson M.D. are for informational purposes only.