ALTHEA J. JACKSON

FORT WAYNE, IN
NPI1306838321
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy207V00000X Obstetrics & Gynecology
(Licence: IN  01052580A)
Additional Taxonomies207V00000X Obstetrics & Gynecology
(Licence: PA  MD040658E)
Enumeration Date2005-08-16
Last Update Date2007-07-08
Business Address
-- ALTHEA J. JACKSON M.D.
2510 E DUPONT RD SUITE 100
FORT WAYNE, IN 46825-1600
Phone number: 260-490-9883
Mailing Address
-- ALTHEA J. JACKSON M.D.
1330 POWELL ST SUITE 507
NORRISTOWN, PA 19401-3353
Phone number: 610-279-9003