Ronnie L. Jackson MD

NPI #1659771350 in Springfield, Tennessee

Provider Information

NPI Number: 1659771350
Entity Type: Organization
Organization Name: Ronnie L. Jackson MD
Primary Specialty: Specialist
Enumeration Date: Aug 29, 2014
Last Updated: Aug 29, 2014

Practice Location

Address: 496 NORTHCREST DR
City: Springfield
State: Tennessee
ZIP Code: 37172-3972
Phone: (615) 382-1037

Authorized Official

Name: MR. RONNIE LEE JACKSON, M.D.
Title: OWNER
Phone: (615) 382-1037

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Specialist	174400000X	Primary

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