Michael Jackson

NPI #1104428473 in Byram, Mississippi

Provider Information

NPI Number: 1104428473
Entity Type: Individual
Name: Michael Jackson
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Driver
Enumeration Date: Nov 12, 2020
Last Updated: Nov 12, 2020

Practice Location

Address: 252 CHARLENE DR
City: Byram
State: Mississippi
ZIP Code: 39272-6418
Phone: (601) 278-2435

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Driver	172A00000X	Primary

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