| NPI | 1184607541 |
|---|---|
| Professional Name | JOHN JACKSON |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208D00000X General Practice (Licence: FL ME37656) |
| Additional Taxonomies | 208D00000X General Practice (Licence: FL 37656) |
| Enumeration Date | 2005-11-21 |
| Last Update Date | 2020-03-27 |