Calvin R. Jackson
Internal Medicine Physician in Augusta, GA(View on Map)
Full Name
Calvin R Jackson
NPI Number
1740398338
NPI Type
Individual Provider
Gender
Male
Enumeration Date
08/25/2006
Specialties
(Taxonomies)Licenses
State
Georgia
South Carolina
License Number
031265
16449
Contact
Information
Purpose
Mailing
Location
Address
2123 WRIGHTSBORO RD
2123 WRIGHTSBORO RD
City
Augusta
Augusta
State
GA
GA
Postal Code
30904-4777
30904-4777
Country
US
US
Telephone Number
(706) 736-5244
(706) 736-5244
Identifiers
Identifier
000623796B
164495
Identifier State
GA
SC
Identifier Issuer
Unknown
Unknown
Provider data last refreshed from NPPES NPI registry on 11/19/2024
Data last updated by provider on 03/28/2008