Search › Tennessee › 103TA0700X
Otis Jackson
NPI 1053710681 · on the registry since 2014
Practice
- Address
- 3311 Kimball Ave
Memphis, TN 38111 - Phone
- (901) 207-4662
- Organisation at this address
- Wright Enhancement Center
Inferred from a shared address, not stated in the registry.
Registry record
- Primary taxonomy
- 103TA0700X
103TA0700X
- Licence states on file
- TN
From the registry's licence fields, which are often incomplete.
- Sex
- Male
- Record last updated
- 2014-08-20
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Tennessee