Provider Demographics
NPI:1811551344
Name:CABO, JACKSON JOSEPH SANDEN (MD)
Entity Type:Individual
Prefix:
First Name:JACKSON
Middle Name:JOSEPH SANDEN
Last Name:CABO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1211 MEDICAL CENTER DR
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37232-0004
Mailing Address - Country:US
Mailing Address - Phone:615-322-2880
Mailing Address - Fax:
Practice Address - Street 1:1161 21ST AVE SOUTH
Practice Address - Street 2:A-1302 MEDICAL CENTER NORTH
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37232-3721
Practice Address - Country:US
Practice Address - Phone:615-322-2880
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-04-30
Last Update Date:2019-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program