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1134177108
THAD JACKSON
ELIZABETHTOWN, KY
NPI
1134177108
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
207T00000X Neurological Surgery
(Licence: KY 34151)
Enumeration Date
2006-05-04
Last Update Date
2012-05-25
Business Address
-- THAD JACKSON MD
1700 RING RD
ELIZABETHTOWN, KY 42701-9497
Phone number: 270-769-5551
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Mailing Address
-- THAD JACKSON MD
1700 RING RD
ELIZABETHTOWN, KY 42701-9497
Phone number: 270-769-5551
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