ANTONIO TERELL JACKSON

ATLANTA, GA
NPI1922749290
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy207P00000X Emergency Medicine
(Licence: GA  96738)
Additional Taxonomies390200000X Student in an Organized Health Care Education/Training Program
Enumeration Date2022-04-02
Last Update Date2025-04-16
Business Address
Mr. ANTONIO TERELL JACKSON
1364 CLIFTON RD NE
ATLANTA, GA 30322-1059
Phone number: 404-727-5658
Mailing Address
Mr. ANTONIO TERELL JACKSON
1364 CLIFTON RD NE
ATLANTA, GA 30322-1059
Phone number: 404-727-5658