Danny Wade Jackson, D.O. Valid NPI
Individual provider · Family Medicine Physician · Rolling Fork, MS
- NPI
- 1821013095
- Type
- Individual (Type 1)
- Primary specialty
- Family Medicine Physician (Family Medicine)
- Specialty group
- Allopathic & Osteopathic Physicians
- Taxonomy code
- 207Q00000X
- License number
- 09390 (MS)
- Sex
- Male
- Sole proprietor
- No
- Enumerated
- 2006-07-12
- Last updated
- 2010-01-21
Practice location
29 S Fourth St
Rolling Fork, MS 39159-5146
(662) 873-4361