Randy Alan Jackson, M.D.

NPI #1689832768 in Texarkana, Texas

Provider Information

NPI Number: 1689832768
Entity Type: Individual
Name: Randy Alan Jackson, M.D.
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Internal Medicine
Credential: M.D.
Enumeration Date: May 27, 2008
Last Updated: May 26, 2009

Practice Location

Address: 2602 SAINT MICHAEL DR
Address 2: SUITE 205
City: Texarkana
State: Texas
ZIP Code: 75503-2387
Phone: (903) 614-5111

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Internal Medicine	207R00000X	Primary

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