| Doctor Name: | DR. JOSEPH J JACKLINE |
| NPI Number: | 1033268792 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | M.D |
| License Number: | 037240 |
| Business Practice Address: | 309 East Main Street Cartersville, GA - 301203335 |
| Business Phone Number: | 7703865262 |
| Business Fax Number: | 7703860502 |
| Mailing Address: | 309 East Main Street, CARTERSVILLE |
| State: | GA |
| Postal Code: | 301203335 |
| Phone Number: | 7703865262 |
| Fax Number: | 7703860502 |
| NPI Enumeration Date: | 01/10/2007 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 207SG0201X |
| License Number: | 037240 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | GA |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | Medical Genetics |
| Taxonomy Specialization: | Clinical Genetics (M.D.) |
| Taxonomy Definition: | A clinical geneticist demonstrates competence in providing comprehensive diagnostic, management and counseling services for genetic disorders. |