LENLEY BRADFORD JACKSON

GALLUP, NM
NPI1568555845
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy207P00000X Emergency Medicine
(Licence: IL  036-119364)
Additional Taxonomies207Q00000X Family Medicine
(Licence: CA  A87877)
Enumeration Date2006-10-01
Last Update Date2011-11-14
Business Address
Dr. LENLEY BRADFORD JACKSON M.D.
516 EAST NIZHONI BLVD.
GALLUP, NM 87301-1337
Phone number: 505-722-1000
Mailing Address
Dr. LENLEY BRADFORD JACKSON M.D.
P.O. BOX 1337
GALLUP, NM 87305-1337
Phone number: 505-722-1000