Mark Kent Jackson

NPI #1063620516 in Athens, Alabama

Provider Information

NPI Number: 1063620516
Entity Type: Individual
Name: Mark Kent Jackson
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Pharmacist
Enumeration Date: May 18, 2007
Last Updated: Jul 8, 2007

Practice Location

Address: 605 HWY 31 SOUTH
Address 2: SUITE D
City: Athens
State: Alabama
ZIP Code: 35611
Phone: (256) 232-8274

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Pharmacist	183500000X	Primary

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