Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
KENNETH JACKSON, PA-C
ActiveKENNETH JACKSON, PA-C is a Medical Physician Assistant healthcare provider located in BERKLEY, Michigan. NPI 1033238936 is currently active in the NPPES registry. Verify at CMS.
Medical Physician Assistant · BERKLEY, MI
Registration Details
- NPI Number
- 1033238936
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Mar 29, 2007 (19.416356825831 yrs)
- Last Updated
- Jan 25, 2021
- License
-
5601001747 (MI)
Practice Information
- Address
-
27901 WOODWARD AVESUITE 300BERKLEY, MI, 480720919Browse MI providers · Browse ZIP 48072
- Phone
- 2488372443
- Primary Specialty
-
Medical Physician Assistant
363AM0700X
Other Medical Physician Assistant Providers in BERKLEY, MI
| Name | Credential | NPI |
|---|---|---|
| MR. CALEB ANTHONY YOUNGBLOOD | MMS, PA-C | 1235366014 |
| VICTORIA THERESE VOROS | PA-C | 1316224108 |
| LAUREN NABORCZYK | PA-C | 1487035275 |
| MRS. BRANDY BLACKSTON | PA-C | 1790158392 |
| MARK ROSEN | PA-C | 1588101091 |
| CLAIRE WILSON | — | 1760999049 |
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.