Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
BRIAN GENE JACKSON, PAC
ActiveBRIAN GENE JACKSON, PAC is a Physician Assistant healthcare provider located in LA JARA, Colorado. NPI 1245261064 is currently active in the NPPES registry. Verify at CMS.
Physician Assistant · LA JARA, CO
Registration Details
- NPI Number
- 1245261064
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Jul 6, 2006 (20.097914093654 yrs)
- Last Updated
- May 6, 2021
- License
-
843 (CO)
Practice Information
- Address
-
509 MAIN STREETLA JARA, CO, 81140Browse CO providers · Browse ZIP 81140
- Phone
- 7193762308
- Fax
- 7193762395
- Primary Specialty
-
Physician Assistant
363A00000X
Other Physician Assistant Providers in LA JARA, CO
| Name | Credential | NPI |
|---|---|---|
| MS. LINDA LEE I | FNP, PA | 1447247655 |
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.