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

JOHNNY JACKSON III

Active Sole Proprietor

JOHNNY JACKSON III is a Peer Specialist healthcare provider located in FAIRFIELD, Ohio. NPI 1336929884 is currently active in the NPPES registry. Verify at CMS.

Peer Specialist · FAIRFIELD, OH

Registration Details

NPI Number
1336929884
Provider Type
Individual
Gender
Male
NPI Issued
Oct 3, 2023 (2.8818559491734 yrs)
Last Updated
Nov 16, 2023
License
APS.004453 (OH)
Sole Proprietor
Yes

Practice Information

Address
6570 SOSNA DR
FAIRFIELD, OH, 450142222
Browse OH providers · Browse ZIP 45014
Phone
5139424673
Fax
5138601439
Primary Specialty
Peer Specialist
175T00000X
Additional Specialty
Case Manager

Other Peer Specialist Providers in FAIRFIELD, OH

Name Credential NPI
JACQUELINE VALENTIN 1619559614
NATASHA HALL 1720768757
JOHN H YOST 1639916570
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.