Provider Demographics
NPI:1043502271
Name:JACKSON, HADYN C (PHARM D)
Entity Type:Individual
Prefix:DR
First Name:HADYN
Middle Name:C
Last Name:JACKSON
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:210 FRANKLIN RD
Mailing Address - Street 2:
Mailing Address - City:BRENTWOOD
Mailing Address - State:TN
Mailing Address - Zip Code:37027-3218
Mailing Address - Country:US
Mailing Address - Phone:615-373-8957
Mailing Address - Fax:615-376-4161
Practice Address - Street 1:210 FRANKLIN RD
Practice Address - Street 2:
Practice Address - City:BRENTWOOD
Practice Address - State:TN
Practice Address - Zip Code:37027-3218
Practice Address - Country:US
Practice Address - Phone:615-373-8957
Practice Address - Fax:615-376-4161
Is Sole Proprietor?:No
Enumeration Date:2011-05-05
Last Update Date:2011-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN34299183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist