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1942263793
CHARLES LEE JACKSON
CHATTANOOGA, TN
NPI
1942263793
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
208800000X Urology
(Licence: TN 41776)
Additional Taxonomies
208800000X Urology
(Licence: FL ME0053658)
Enumeration Date
2006-04-11
Last Update Date
2010-06-04
Business Address
CHARLES LEE JACKSON MD
725 GLENWOOD DR STE E790
CHATTANOOGA, TN 37404-1178
Phone number: 423-495-3068
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Mailing Address
CHARLES LEE JACKSON MD
725 GLENWOOD DR STE E790
CHATTANOOGA, TN 37404-1178
Phone number: 423-495-3068
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