Search › Arkansas › 224Z00000X
Willie D Jackson
NPI 1225717515 · on the registry since 2023 · sole proprietor
Practice
- Address
- 1310 S Linden St
Pine Bluff, AR 71603 - Phone
- (870) 360-1777
- Organisation at this address
- Clifton G Roaf & Marvin Q Caudle
Inferred from a shared address, not stated in the registry.
Registry record
- Primary taxonomy
- 224Z00000X
224Z00000X
- Also registered as
- 126800000X
- Licence states on file
- AR
From the registry's licence fields, which are often incomplete.
- Sex
- Female
- Record last updated
- 2023-07-13
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 Arkansas