| Doctor Name: | DR. HOWARD C JACKSON |
| NPI Number: | 1437149945 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | MD |
| License Number: | 01019775 |
| Business Practice Address: | 711 Green Rd Madison, IN - 472502199 |
| Business Phone Number: | 8122652611 |
| Business Fax Number: | 8122657227 |
| Mailing Address: | 711 Green Rd, MADISON |
| State: | IN |
| Postal Code: | 472502199 |
| Phone Number: | 8122657225 |
| Fax Number: | 8122657227 |
| NPI Enumeration Date: | 10/26/2005 |
| NPI Last Update Date: | 01/28/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | 08/20/2007 |
| NPI Reactivation Date: | 01/28/2008 |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | 01019775 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | IN |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |