| Dennis M Jackson Md Inc | |
|
460 Saint Michaels Dr #1005 Santa Fe NM 87505-7619 | |
| (505) 490-9738 | |
| Not Available |
| Full Name | Dennis M Jackson Md Inc |
|---|---|
| Speciality | Family Medicine |
| Location | 460 Saint Michaels Dr, Santa Fe, New Mexico |
| Authorized Official Name and Position | Dennis M Jackson (PRESIDENT) |
| Authorized Official Contact | 5054909738 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Dennis M Jackson Md Inc 5112 Hollywood Blvd #111 Pmb 106 Los Angeles CA 90027-6126 Ph: (505) 490-9738 | Dennis M Jackson Md Inc 460 Saint Michaels Dr #1005 Santa Fe NM 87505-7619 Ph: (505) 490-9738 |
| NPI Number | 1194969220 |
|---|---|
| Provider Enumeration Date | 04/20/2009 |
| Last Update Date | 04/20/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1194969220 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 70142 (New Mexico) | Primary |
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