Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Dr. Willie Mae Jackson, MD

Individual provider Student in an Organized Health Care Education/Training Program · NPI 1073754065

Dr. Willie Mae Jackson, MD is a Student in an Organized Health Care Education/Training Program in Owensboro, Kentucky. Works from 2 locations. Licensed in Kentucky.

Licensed in
KY
In the registry since
2009
Specialties on file
2
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

2211 Mayfair Dr Ste 409
Owensboro, KY 42301-4568
Phone: (270) 417-7980
Fax: (270) 417-7989
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 601 W 2nd St, Bloomington, IN 47403-2317 — (812) 353-3450

Specialties & licences

Psychiatry Physician (primary) Taxonomy 2084P0800X · Licence 46400 (KY)
Student in an Organized Health Care Education/Training Program Taxonomy 390200000X

Record details

NPI number1073754065
Entity typeIndividual (Type 1)
GenderFemale
Credentials MD
Sole proprietorNo
NPI enumeratedMarch 20, 2009
Last updated in NPPESNovember 4, 2020
Certification dateNovember 4, 2020
Mailing addressPo Box 23229, Owensboro, KY 42304-3229

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