Jackson Medical Clinic, PC

NPI #1457594699 in Wagoner, Oklahoma

Provider Information

NPI Number: 1457594699
Entity Type: Organization
Organization Name: Jackson Medical Clinic, PC
Primary Specialty: General Practice
Enumeration Date: Apr 17, 2009
Last Updated: Mar 22, 2017

Practice Location

Address: 410 E CHEROKEE ST
City: Wagoner
State: Oklahoma
ZIP Code: 74467-4708
Phone: (918) 485-5591

Authorized Official

Name: KELLY NOEL HALEY
Title: OFFICE MANAGER
Phone: (918) 485-5591

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
General Practice	208D00000X	Primary

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Next Generation Family Medical Clinic, LLC	General Practice	Wagoner	AI Deep Dive

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