Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
RUSSELL PATRICK JACKSON
Active Sole ProprietorRUSSELL PATRICK JACKSON is a Medical Physician Assistant healthcare provider located in CASA GRANDE, Arizona. NPI 1699322578 is currently active in the NPPES registry. Verify at CMS.
Medical Physician Assistant · CASA GRANDE, AZ
Registration Details
- NPI Number
- 1699322578
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Aug 24, 2019 (6.9527524660023 yrs)
- Last Updated
- Sep 6, 2024
- License
-
8654 (AZ)
- Sole Proprietor
- Yes
Practice Information
- Address
-
301 E COTTONWOOD LN STE 1&2CASA GRANDE, AZ, 851222551Browse AZ providers · Browse ZIP 85122
- Phone
- 6025693999
- Fax
- 5203404359
- Primary Specialty
-
Medical Physician Assistant
363AM0700X
- Additional Specialty
- Medical Physician Assistant
Other Medical Physician Assistant Providers in CASA GRANDE, AZ
| Name | Credential | NPI |
|---|---|---|
| MR. ROBERT JOSEPH SEALS JR. | PA-C | 1184654816 |
| DEREK B CARPENTER | PA-C | 1114320959 |
| AARON TIMOTHY NEWTON | PA-C | 1114325289 |
| ALIVIA WIESELER | — | 1588043475 |
| ZACHARY KOPECKY | PA-C | 1730859992 |
| SAVANNAH MARIE WALKER | MPAS | 1134804925 |
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.