Healthcare Provider Details

I. General information

NPI: 1740860725
Provider Name (Legal Business Name): WILLIAM CHRISTOPHER JACKSON DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/13/2021
Last Update Date: 04/07/2025
Certification Date: 04/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

701 PRINCETON AVE SW
BIRMINGHAM AL
35211-1303
US

IV. Provider business mailing address

833 PRINCETON AVENUE SW PROFESSIONAL OFFICE BUILDING 3, SUITE 200-E
BIRMINGHAM AL
35211
US

V. Phone/Fax

Practice location:
  • Phone: 205-783-3000
  • Fax:
Mailing address:
  • Phone: 205-971-5745
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License NumberDO.3082
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: