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Dewell Jackson
NPI 1700135977 · on the registry since 2012 · sole proprietor
Practice
- Address
- 5093 Hardy St
Hattiesburg, MS 39401 - Phone
- (601) 579-7465
- Organisation at this address
- Walgreen Co
Inferred from a shared address, not stated in the registry.
- Clinicians at this address
- 20
Registry record
- Primary taxonomy
- 183500000X
183500000X
- Licence states on file
- MS
From the registry's licence fields, which are often incomplete.
- Sex
- Male
- Record last updated
- 2012-09-04
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 Mississippi