NPI 1629076864

Billy Michael Jackson, MD

Practitioner Surgery Physician Los Alamos, NM

Practice location

Address: 3917 West Rd Suite 150, Los Alamos, NM 87544
Phone: (505) 662-4351
Fax: (505) 662-4351

Registered specialties

Surgery Physician Primary

Allopathic & Osteopathic Physicians Taxonomy 208600000X Licence 72160 (NM)

Other Surgery providers in New Mexico →

Registry record

NPI: 1629076864
Entity type: Individual
Sex (as registered): Male
NPI issued: 12 Jul 2005
Record last updated: 16 Apr 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.