RANDY H JACKSON

GAINESVILLE, GA
NPI1629010707
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy363AM0700X Physician Assistant, Medical
(Licence: GA  002048)
Enumeration Date2006-06-12
Last Update Date2007-11-07
Business Address
-- RANDY H JACKSON PA
743 SPRING ST NE
GAINESVILLE, GA 30501-3715
Phone number: 770-536-2146
Mailing Address
-- RANDY H JACKSON PA
PO BOX 2938
GAINESVILLE, GA 30503-2938
Phone number: 770-536-2146
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