Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
RICHARD E JACKSON, PA-C
Active Sole ProprietorRICHARD E JACKSON, PA-C is a Surgical Physician Assistant healthcare provider located in PORT CHARLOTTE, Florida. NPI 1174587505 is currently active in the NPPES registry. Verify at CMS.
Surgical Physician Assistant · PORT CHARLOTTE, FL
Registration Details
- NPI Number
- 1174587505
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Apr 13, 2006 (20.380712855048 yrs)
- Last Updated
- Sep 9, 2020
- License
-
PA2962 (FL)
- Sole Proprietor
- Yes
Practice Information
- Address
-
21260 OLEAN BLVD STE 200PORT CHARLOTTE, FL, 339526742Browse FL providers · Browse ZIP 33952
- Phone
- 9416254270
- Fax
- 9416251751
- Primary Specialty
-
Surgical Physician Assistant
363AS0400X
Other Surgical Physician Assistant Providers in PORT CHARLOTTE, FL
| Name | Credential | NPI |
|---|---|---|
| IRIS JEANNE SWIDERSKI | DHSC, PA-C | 1154754711 |
| KENDALL KAREN MAROTTI | P.A. | 1457900862 |
| ANDREA BERECZ-PREWITT | — | 1750930731 |
| GRACE COLAROSSI | — | 1063231264 |
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.