Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
MR. TIMOTHY LAWRENCE JACKSON, PA
Active Sole ProprietorMR. TIMOTHY LAWRENCE JACKSON, PA is a Medical Physician Assistant healthcare provider located in WILLIAMS, Arizona. NPI 1124338504 is currently active in the NPPES registry. Verify at CMS.
Medical Physician Assistant · WILLIAMS, AZ
Registration Details
- NPI Number
- 1124338504
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Oct 19, 2010 (15.821594942899 yrs)
- Last Updated
- Jul 21, 2021
- License
-
5407 (AZ)
- Sole Proprietor
- Yes
Practice Information
- Address
-
300 S 6TH STWILLIAMS, AZ, 860460110Browse AZ providers · Browse ZIP 86046
- Phone
- 9286354441
- Primary Specialty
-
Medical Physician Assistant
363AM0700X
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.