TERESA L JACKSON MD PC
Medical Practice at Tangerine Rd, Tucson, AZ

License number
Arizona 32627
Category
Medical Practice
Type
Plastic Surgery
Owner
Name: TERESA L JACKSON MD
Title: PRESIDENT
Phone: (520) 531-0700
Address
Address
1521 E Tangerine Rd #331, Tucson, AZ 85755
National Provider ID: 1518005610
LicenseFiles verified this license of Nov 7, 2017 at the National Plan and Provider Enumeration System.

Organization information

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TERESA L. JACKSON, M.D., PC

Suite 13 SUITE 131, Tucson, AZ 85718

Status:
Inactive
Inactive reason:
Ad-dissolved-file annual report
Registration:
Jul 6, 2005
Inactive since:
Jan 19, 2011
State ID:
-1213092-1
Expiration:
PERPETUAL
President/ceo:
Teresa L Jackson Md Pc (President/ceo), 4207 W Tellurite Dr, Tucson, AZ 85745 (Physical)
Agent:
Gregory V Gadarian,2200 E Riv Rd STE 123, Tucson, AZ 85718 (Physical)
Business type:
HEALTH CARE

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