Michael Ray Jackson M.D.

NPI 1053467902 - Family Medicine - 207Q00000X

NPI Details
NPI 1053467902
Gender Male
Enumeration Date 01/25/2007
Last Updated 09/12/2012
Entity Type Individual
Active Over 9 years ago
Practice Location
103 N FIRST ST
ROCKWALL TX, 75087-3033, US
Phone (972) 771-5366
Fax (972) 771-0424
Business Location
103 N FIRST ST
ROCKWALL TX, 75087-3033, US
Phone (972) 771-5366
Fax (972) 771-0424
Toxanomy
Taxonomy Code 207Q00000X
License State Oklahoma
License Number 19730
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According to our database, Dr. Michael Ray Jackson M.D. NPI is 1053467902, taxonomy code is 207Q00000X and license number is 19730, license state is located at Oklahoma. Michael Ray Jackson M.D. physically located at 103 N First St, Rockwall TX, 75087-3033. NPI Number Michael Ray Jackson M.D. has the Individual type.

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1053467902 NPI number is provided on an as is basis without warranty of any kind. 1053467902 is maintained by the National Plan & Provider Enumeration System. The contents of Michael Ray Jackson M.D. are for informational purposes only.