institution
Jackson Medical Clinic, Pc
General Practice Physician in Wagoner, Oklahoma
NPI 1457594699

Jackson Medical Clinic, Pc is a General Practice Physician based in Wagoner, OK. Jackson Medical Clinic, Pc practices in Wagoner, OK. The NPI Number for Jackson Medical Clinic, Pc is 1457594699 and holds a License No. 28153 (Oklahoma).

The current practice location address for Jackson Medical Clinic, Pc is 410 E Cherokee St, Wagoner, OK and can be reached out via phone at 918-485-5591 and via fax at 918-485-5758.

Location: 410 E Cherokee St, Wagoner, OK, 74467-4708
institution
Provider Profile Details
NPI Number
1457594699
Provider Name
Jackson Medical Clinic, Pc
Credential
Provider Entity Type
Organization
Address
410 E Cherokee St, Wagoner, OK, 74467-4708
Phone Number
918-485-5591
Fax Number
918-485-5758
Provider Enumeration Date
04/17/2009
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
100141080E 05 OK
institution
Provider Business Practice Location Address Details
Address
410 E Cherokee St
City
State
Zip
74467-4708
Phone Number
918-485-5591
Fax Number
918-485-5758
person
Provider Business Mailing Address Details
Address
410 E Cherokee St
City
State
Zip
74467-4708
Phone Number
918-485-5591
Fax Number
918-485-5758
person
Provider's Taxonomy Details 1
Type
Allopathic & Osteopathic Physicians
Classification
General Practice
Speciality
-
Taxonomy
License No.
28153 (Oklahoma)
Definition
Definition to come...
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