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1205839362
IVAN D. JACKSON
DOTHAN, AL
NPI
1205839362
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
207R00000X Internal Medicine
(Licence: AL 11508)
Enumeration Date
2005-05-23
Last Update Date
2021-03-03
Business Address
Dr. IVAN D. JACKSON MD
210 WESTSIDE DR
DOTHAN, AL 36303-1928
Phone number: 334-793-5074
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Mailing Address
Dr. IVAN D. JACKSON MD
210 WESTSIDE DR
DOTHAN, AL 36303-1928
Phone number: 334-793-5074
Copy
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