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Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

MR. JAVITS L JACKSON

Active Sole Proprietor

MR. JAVITS L JACKSON is a Van Provider healthcare provider located in PINE BLUFF, Arkansas. NPI 1104506799 is currently active in the NPPES registry. Verify at CMS.

Van Provider · PINE BLUFF, AR

Registration Details

NPI Number
1104506799
Provider Type
Individual
Gender
Male
NPI Issued
Jul 19, 2023 (3.0680916577517 yrs)
Last Updated
Jul 19, 2023
Sole Proprietor
Yes

Practice Information

Address
8 WHITE TAIL CV
PINE BLUFF, AR, 716038149
Browse AR providers · Browse ZIP 71603
Phone
8707181186
Primary Specialty
Van Provider
344600000X
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.