Most Relevant Information
Provider Data
| NPI Number: | 1003018136 |
| Provider Name: | ANGELA CHASE JACKSON PA-C |
| Entity Type: | Individual |
| Taxonomy Code: | 363A00000X |
| Specialty: | Physician Assistant |
| License Number: |
Most Important Dates
| Enumeration Date: | 06/01/2007 |
| Last Updated: | 07/08/2007 |
Provider Practice Location
413 OWEN DRIVE
SUITE 201
FAYETTEVILLE
NC
283043411
Practice Location Phone/Fax
| Phone: | 9103239111 |
| Fax: | 9104842535 |
Provider Mailing Location
413 OWEN DRIVE
SUITE 201
FAYETTEVILLE
NC
283043411
Provider Mailing Phone/Fax
| Phone: | 9103239111 |
| Fax: | 9104842535 |