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Farris Jackson JR., MD
Specialist in St Louis, Missouri
NPI 1083618904

Farris Jackson JR. is a Specialist based in St Louis, MO. Farris Jackson JR. practices in St Louis, MO and has the professional credentials of MD. The NPI Number for Farris Jackson JR. is 1083618904 and holds a License No. R9F09 (Missouri).

The current practice location address for Farris Jackson JR. is 11200 Tesson Ferry Rd., St Louis, MO and can be reached out via phone at 314-849-1500 and via fax at 314-849-8789.

Location: 11200 Tesson Ferry Rd., St Louis, MO, 63123-6922
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1083618904
Provider Name
Farris Jackson JR.
Credential
MD
Provider Entity Type
Individual
Gender
Male
Address
11200 Tesson Ferry Rd., St Louis, MO, 63123-6922
Phone Number
314-849-1500
Fax Number
314-849-8789
Provider Enumeration Date
06/09/2005
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
290013015 01 MO MEDICARE RAILROAD
202531513 05 MO
institution
Provider Business Practice Location Address Details
Address
11200 Tesson Ferry Rd.
City
St Louis
State
Missouri
Zip
63123-6922
Phone Number
314-849-1500
Fax Number
314-849-8789
person
Provider Business Mailing Address Details
Address
11200 Tesson Ferry Rd.
City
St Louis
State
Missouri
Zip
63123-6922
Phone Number
314-849-1500
Fax Number
314-849-8789
person
Provider's Taxonomy Details 1
Type
Other Service Providers
Classification
Specialist
Speciality
-
Taxonomy
174400000X
License No.
R9F09 (Missouri)
Definition
An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.
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