Provider Demographics
NPI:1730213638
Name:JACKSON, TAMAR YOLANDA (MD)
Entity type:Individual
Prefix:MS
First Name:TAMAR
Middle Name:YOLANDA
Last Name:JACKSON
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:131 CONTINENTAL DR
Mailing Address - Street 2:SUITE 200
Mailing Address - City:NEWARK
Mailing Address - State:DE
Mailing Address - Zip Code:19713-4305
Mailing Address - Country:US
Mailing Address - Phone:302-366-1868
Mailing Address - Fax:302-366-8572
Practice Address - Street 1:4755 OGLETOWN STANTON RD
Practice Address - Street 2:CHRISTIANA CARE HOSPITAL
Practice Address - City:NEWARK
Practice Address - State:DE
Practice Address - Zip Code:19718-2200
Practice Address - Country:US
Practice Address - Phone:302-733-5586
Practice Address - Fax:302-733-5833
Is Sole Proprietor?:No
Enumeration Date:2007-03-15
Last Update Date:2022-01-24
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
DEC70003469207R00000X
DEC1-0009102207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine