GARY L. JACKSON

RUIDOSO, NM
NPI1578692331
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy207R00000X Internal Medicine
(Licence: NM  A-903-90)
Enumeration Date2007-03-05
Last Update Date2008-08-14
Business Address
GARY L. JACKSON DO
LINCOLN COUNTY MEDICAL CENTER 211 SUDDERTH
RUIDOSO, NM 88345
Phone number: 505-257-8200
Mailing Address
GARY L. JACKSON DO
PO BOX 26666 PHS PROVIDER ENROLLMENT
ALBUQUERQUE, NM 87125-6666
Phone number: 505-923-5356
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