Search › Georgia › 111N00000X
Gregory Jackson
NPI 1972179018 · on the registry since 2021 · sole proprietor
Practice
- Address
- 3640 S Fulton Ave Unit 1411
Hapeville, GA 30354 - Phone
- (424) 284-9663
Registry record
- Primary taxonomy
- 111N00000X
111N00000X
- Licence states on file
- GA
From the registry's licence fields, which are often incomplete.
- Sex
- Male
- Record last updated
- 2021-05-30
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 Georgia