Doctor Name: | LEON S JACKSON |
NPI Number: | 1285622175 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | MD |
License Number: | G68430 |
Business Practice Address: | 118 E Haskell St Winnemucca, NV - 894453247 |
Business Phone Number: | 6087888103 |
Business Fax Number: | 6087888799 |
Mailing Address: | 2031 32nd St S, LA CROSSE |
State: | WI |
Postal Code: | 546017099 |
Phone Number: | 6087888103 |
Fax Number: | 6087888799 |
NPI Enumeration Date: | 10/13/2005 |
NPI Last Update Date: | 07/24/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 2085R0202X |
License Number: | G68430 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | CA |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | Radiology |
Taxonomy Specialization: | Diagnostic Radiology |
Taxonomy Definition: | A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. |