Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
KENNETH WILLIAM JACKSON, PA
Active Sole ProprietorKENNETH WILLIAM JACKSON, PA is a Physician Assistant healthcare provider located in CORBIN, Kentucky. NPI 1194587824 is currently active in the NPPES registry. Verify at CMS.
Physician Assistant · CORBIN, KY
Registration Details
- NPI Number
- 1194587824
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Jan 29, 2024 (2.5221296735431 yrs)
- Last Updated
- Oct 11, 2024
- License
-
TC075 (KY)
- Sole Proprietor
- Yes
Practice Information
- Address
-
2 TRILLIUM WAY STE 106CORBIN, KY, 407018426Browse KY providers · Browse ZIP 40701
- Phone
- 6065264070
- Fax
- 6065264072
- Primary Specialty
-
Physician Assistant
363A00000X
Other Physician Assistant Providers in CORBIN, KY
| Name | Credential | NPI |
|---|---|---|
| INGRID MINOR | PA-C | 1841248507 |
| CYNTHIA L DANIEL | PA-C | 1831143833 |
| LAURA CLIFTON | PA-C | 1649219767 |
| JOSEPH R. REED | P.A.-C. | 1821193525 |
| DAVID C BIRCH | PA | 1508928896 |
| JOSEPH T SHELTON | PA | 1316009509 |
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.