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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