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EUGENE HOOKS JACKSON MD
>> Family Medicine >> Allopathic & Osteopathic PhysiciansRegistrant NPI Number: 1538165386
Individual Registrant: EUGENE HOOKS JACKSON MD
Gender: M
Not Sole Proprietor
Gender: M
Not Sole Proprietor
Location and contact information for practice:
118 NORMAN DORMINY DR FITZGERALD, GA 31750-8858 US
Tel: 229-423-9561 Fax: --
Tel: 229-423-9561 Fax: --
Contact information for business:
PO BOX 1447 FITZGERALD, GA 31750-1447 US
Tel: 229-423-9561 Fax: 229-424-7097
Tel: 229-423-9561 Fax: 229-424-7097
Registration Information:
NPI: 1538165386
Entity Type: Individual
Entity Type: Individual
Specialty information:
| Primary | Code | Category/Description | State | License Number |
|---|---|---|---|---|
| Y | 207Q00000X | Allopathic & Osteopathic Physicians Family Medicine | GA | 022793 |
Legacy codes, insurance codes and state license numbers:
| Issuer | Number | State | Type |
|---|---|---|---|
