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1659330108
DEWEY THOMAS JACKSON
FAIRPORT, NY
NPI
1659330108
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
207R00000X Internal Medicine
(Licence: NY 136492)
Enumeration Date
2006-03-22
Last Update Date
2007-07-08
Business Address
Mr. DEWEY THOMAS JACKSON MD
2828 BAIRD RD
FAIRPORT, NY 14450-1247
Phone number: 585-248-9670
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Mailing Address
Mr. DEWEY THOMAS JACKSON MD
2828 BAIRD RD
FAIRPORT, NY 14450-1247
Phone number: 585-248-9670
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