Kimberly Funches jackson

Medical doctor

Phenix City, United States

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Full name

Kimberly Funches Jackson

Job Title

Medical Doctor

Location

Phenix City, AL, USA

LIC ID

145108

Current License Expiration Date

31/01/2026

Original Date

09/10/2019

Professional Rank Code

Effective Date

15/03/2023

Board Action Indicator

License Status Description

CLEAR

License Active Status Description

ACTIVE

Country Description

Out of State

Practice Location Address Line 1

1810 STADIUM DRIVE - STE 210

Practice Location Address City

PHENIX CITY

Practice Location Address State

Practice Location Address Zipcode

36867

Mode Code

Dispensing Practitioner

Prescribing Indicator

Dispensing Indicator

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