DR. Thad M Jackson, D.O.

NPI #1891782421 in Grayling, Michigan

Provider Information

NPI Number: 1891782421
Entity Type: Individual
Name: DR. Thad M Jackson, D.O.
Gender: Not Specified
Sole Proprietor: Not Answered
Primary Specialty: Family Medicine
Credential: D.O.
Enumeration Date: Sep 29, 2005
Last Updated: Jul 8, 2007

Practice Location

Address: 1010 W NORTH DOWN RIVER RD
City: Grayling
State: Michigan
ZIP Code: 49738-2060
Phone: (989) 348-7671

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Family Medicine	207Q00000X	Primary

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