Jackson Vaughan Littlejohn, MD
Student in an Organized Health Care Education/Training Program in Arlington, TX. Individual provider (NPI-1).
NPI number1124604152
StatusActive
Last updated in NPPESDec 24, 2024
Details
- NPI
- 1124604152
- Entity type
- Individual (NPI-1)
- Name
- Jackson Vaughan Littlejohn
- Credential
- MD
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Mar 21, 2021
- Certification date
- Dec 24, 2024
- Last updated
- Dec 24, 2024
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 390200000X | Student in an Organized Health Care Education/Training Program | – | – | Yes |
| 207R00000X | Internal Medicine | U8765 | TX |
Practice location
3301 Matlock RdArlington, TX 76015-2908
Phone 817-347-1141
Mailing address
3301 Matlock RdArlington, TX 76015-2908
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