Organization · Type 2 NPI
Jackson Medical Clinic, PC
General Practice Physician · Wagoner, OK
NPI number
1457594699
Active
Practice location
410 E Cherokee St
Wagoner, OK 74467-4708
Fax (918) 485-5758
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| General Practice Physician Primary | 208D00000X | 28153 (OK) |
General Practice Physician: A physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions.
2 other providers at this address
Other general practice physician providers in Wagoner
About NPI 1457594699
Jackson Medical Clinic, PC's National Provider Identifier is 1457594699, issued on Apr 17, 2009. The primary taxonomy on file is General Practice Physician (208D00000X), and the practice location is in Wagoner, OK. The record was last updated on Mar 22, 2017.