| Grace E. Jackson, Md, Pllc | |
|
115 S Candy Ln Ste C2 Cottonwood AZ 86326-4188 | |
| (928) 649-6736 | |
| Not Available |
| Full Name | Grace E. Jackson, Md, Pllc |
|---|---|
| Speciality | Psychiatry & Neurology - Psychiatry |
| Location | 115 S Candy Ln Ste C2, Cottonwood, Arizona |
| Authorized Official Name and Position | Grace E Jackson (CEO) |
| Authorized Official Contact | 9286496736 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Grace E. Jackson, Md, Pllc 115 S Candy Ln Ste C2 Cottonwood AZ 86326-4188 Ph: (928) 649-6736 | Grace E. Jackson, Md, Pllc 115 S Candy Ln Ste C2 Cottonwood AZ 86326-4188 Ph: (928) 649-6736 |
| NPI Number | 1568863322 |
|---|---|
| Provider Enumeration Date | 09/11/2014 |
| Last Update Date | 10/14/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1568863322 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | 46710 (Arizona) | Primary |
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