AUDRA M JACKSON

FORT SMITH, AR
NPI1093815268
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy207Q00000X Family Medicine
(Licence: AR  E6098)
Additional Taxonomies390200000X Student in an Organized Health Care Education/Training Program
Enumeration Date2006-09-25
Last Update Date2010-08-23
Business Address
-- AUDRA M JACKSON MD
3808 SOUTH GARY
FORT SMITH, AR 72903-5450
Phone number: 479-709-7120
Mailing Address
-- AUDRA M JACKSON MD
PO BOX 402319
ATLANTA, GA 30384-2319
Phone number: 479-709-7399