Provider Demographics
NPI:1285155259
Name:TURNER, JACKSON BROOKS (MD)
Entity type:Individual
Prefix:
First Name:JACKSON
Middle Name:BROOKS
Last Name:TURNER
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:239 N RIDGEWOOD AVENUE
Mailing Address - Street 2:
Mailing Address - City:EDGEWATER
Mailing Address - State:FL
Mailing Address - Zip Code:32132
Mailing Address - Country:US
Mailing Address - Phone:386-427-4868
Mailing Address - Fax:386-427-6350
Practice Address - Street 1:239 N RIDGEWOOD AVE
Practice Address - Street 2:
Practice Address - City:EDGEWATER
Practice Address - State:FL
Practice Address - Zip Code:32132-1734
Practice Address - Country:US
Practice Address - Phone:386-427-4868
Practice Address - Fax:386-427-6350
Is Sole Proprietor?:No
Enumeration Date:2017-06-29
Last Update Date:2025-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME138933207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine