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1114956562
MARK L JACKSON
PHOENIX, AZ
NPI
1114956562
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
2085R0202X Radiology, Diagnostic Radiology
(Licence: AZ 15432)
Enumeration Date
2006-06-30
Last Update Date
2007-07-08
Business Address
Dr. MARK L JACKSON M.D.
11209 N TATUM BLVD SUITE 110
PHOENIX, AZ 85028-3091
Phone number: 602-248-8002
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Mailing Address
Dr. MARK L JACKSON M.D.
PO BOX 14687
SCOTTSDALE, AZ 85267-4687
Phone number: 480-991-8100
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