Dorshey Jackson, MD
Family Medicine in Syracuse, NY. Individual provider (NPI-1).
NPI number1154909752
StatusActive
Last updated in NPPESAug 13, 2024
Details
- NPI
- 1154909752
- Entity type
- Individual (NPI-1)
- Name
- Dorshey Jackson
- Credential
- MD
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Apr 1, 2021
- Certification date
- Aug 13, 2024
- Last updated
- Aug 13, 2024
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207Q00000X | Family Medicine | 332383 | NY | Yes |
Practice location
321 Gifford StSyracuse, NY 13204-3201
Phone 315-703-2600
Mailing address
321 Gifford StSyracuse, NY 13204-3201
Phone 315-703-2600
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