OrganizationActive
Dr. Danny W Jackson D.O. PA
NPI 1659304301 · Clinical Medical Laboratory · Rolling Fork, MS
Provider details
- NPI number
- 1659304301
- Entity type
- Organization
- Primary specialty
- Clinical Medical LaboratoryLaboratories
- Organization subpart
- No
- Authorized official
- Danny Jackson, Owner(662) 873-4361
Specialties & taxonomies
Laboratories
Practice location
29 S Fourth St
Rolling Fork, MS 39159-5146
Phone: (662) 873-4361
Fax: (662) 873-2921
Approximate (ZIP-level) locationGet directions
Mailing address
Po Box 520
Rolling Fork, MS 39159-0520
Registry dates
- Enumerated
- 2006-07-08
- Last updated
- 2020-08-22
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.