SAMUEL ROBERT JACKSON

ROANOKE, VA
NPI1699274993
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy363A00000X Physician Assistant
(Licence: VA  0110006058)
Enumeration Date2018-02-02
Last Update Date2018-02-02
Business Address
Mr. SAMUEL ROBERT JACKSON PA
1906 BELLEVIEW AVE SE
ROANOKE, VA 24014-1838
Phone number: 540-981-7000
Mailing Address
Mr. SAMUEL ROBERT JACKSON PA
719 ARBUTUS AVE SE
ROANOKE, VA 24014-2503
Phone number: 404-983-5673
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