Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
CHAD EDWIN JACKSON, MS, ATC
Active Sole ProprietorCHAD EDWIN JACKSON, MS, ATC is a 2083S0010X healthcare provider located in FORT MYERS, Florida. NPI 1518484245 is currently active in the NPPES registry. Verify at CMS.
2083S0010X · FORT MYERS, FL
Registration Details
- NPI Number
- 1518484245
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Aug 24, 2017 (8.9350726791755 yrs)
- Last Updated
- Aug 24, 2017
- License
-
AL2986 (FL)
- Sole Proprietor
- Yes
Practice Information
- Address
-
14110 SIX MILE CYPRESS PKWYFORT MYERS, FL, 339124314Browse FL providers · Browse ZIP 33912
- Phone
- 2394796411
- Fax
- 2397682032
- Primary Specialty
-
2083S0010X
2083S0010X
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.