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1528289881
MARK JACKSON
FORT YATES, ND
NPI
1528289881
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
2083P0901X Preventive Medicine, Public Health & General Preventive Medicine
(Licence: ME 012211)
Enumeration Date
2007-05-02
Last Update Date
2008-06-27
Business Address
Dr. MARK JACKSON MD
10 STANDING ROCK AGENCY AVENUE
FORT YATES, ND 58538
Phone number: 701-854-3831
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Mailing Address
Dr. MARK JACKSON MD
10 RIVER ROAD
FORT YATES, ND 58538-0179
Phone number: 701-854-3831
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