NPI 1528289881

Mark Jackson, MD

Practitioner Public Health & General Preventive Medicine Physician Fort Yates, ND

Practice location

Address: 10 Standing Rock Agency Avenue, Fort Yates, ND 58538
Phone: (701) 854-3831
Fax: (701) 854-7411
Mailing address: 10 River Road, Fort Yates, ND 58538-0179

Registered specialties

Public Health & General Preventive Medicine Physician Primary

Allopathic & Osteopathic Physicians Taxonomy 2083P0901X Licence 012211 (ME)

Other Preventive Medicine providers in North Dakota →

Registry record

NPI: 1528289881
Entity type: Individual
Sex (as registered): Male
NPI issued: 2 May 2007
Record last updated: 27 Jun 2008

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.