| Horace J Jackson MD PC | |
|
505 W Leigh Street Suite 207 Richmond VA 23220 | |
| (804) 788-0556 | |
| (804) 788-1141 |
| Full Name | Horace J Jackson MD PC |
|---|---|
| Speciality | Internal Medicine - Gastroenterology |
| Location | 505 W Leigh Street, Richmond, Virginia |
| Authorized Official Name and Position | Horace J Jackson (PRESIDENT OWNER) |
| Authorized Official Contact | 8047880556 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Horace J Jackson MD PC 505 W Leigh Street Suite 207 Richmond VA 23220 Ph: (804) 788-0556 | Horace J Jackson MD PC 505 W Leigh Street Suite 207 Richmond VA 23220 Ph: (804) 788-0556 |
| NPI Number | 1851324958 |
|---|---|
| Provider Enumeration Date | 07/09/2006 |
| Last Update Date | 06/24/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1851324958 | NPI | - | NPPES |
| 006954 | Other | VA | ANTHEM BS |
| 006O49656 | Medicaid | VA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RG0100X | Internal Medicine - Gastroenterology | (NU) | Primary |
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