DR. Jackson L Gates, M.D.

NPI #1962418400 in Conyers, Georgia

Provider Information

NPI Number: 1962418400
Entity Type: Individual
Name: DR. Jackson L Gates, M.D.
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: General Practice
Credential: M.D.
Enumeration Date: Aug 1, 2006
Last Updated: Aug 10, 2010

Practice Location

Address: 1880 LANCASTER DRIVE
City: Conyers
State: Georgia
ZIP Code: 30013-6433
Phone: (678) 591-6509

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
General Practice	208D00000X	Primary
Pathology - Anatomic Pathology & Clinical Pathology — Anatomic Pathology & Clinical Pathology	207ZP0102X

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