| Jackson Family Practice, LLC | |
|
506 Harley St Scottsboro AL 35768-4219 | |
| (256) 574-6157 | |
| (256) 259-0560 |
| Full Name | Jackson Family Practice, LLC |
|---|---|
| Speciality | Family Medicine |
| Location | 506 Harley St, Scottsboro, Alabama |
| Authorized Official Name and Position | Oscar V, Fadul (OWNER) |
| Authorized Official Contact | 2565746157 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Jackson Family Practice, LLC Po Box 56 Scottsboro AL 35768-0056 Ph: (256) 574-6157 | Jackson Family Practice, LLC 506 Harley St Scottsboro AL 35768-4219 Ph: (256) 574-6157 |
| NPI Number | 1982935532 |
|---|---|
| Provider Enumeration Date | 01/21/2010 |
| Last Update Date | 01/21/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1982935532 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | MD.9585 (Alabama) | Primary |
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