Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
DR. SUSAN MARIE JACKSON, D.O.
ActiveDR. SUSAN MARIE JACKSON, D.O. is a Family Medicine healthcare provider located in HALLSTEAD, Pennsylvania. NPI 1780749671 is currently active in the NPPES registry. Verify at CMS.
Family Medicine · HALLSTEAD, PA
Registration Details
- NPI Number
- 1780749671
- Provider Type
- Individual
- Gender
- Female
- NPI Issued
- Dec 22, 2006 (19.642487243253 yrs)
- Last Updated
- May 8, 2013
- Licenses
-
2000163890 (MO)244722 (NY)OS015552 (PA)
Practice Information
- Address
-
25066 SR 11HALLSTEAD, PA, 18822Browse PA providers · Browse ZIP 18822
- Phone
- 5708795249
- Fax
- 5708792418
- Primary Specialty
-
Family Medicine
207Q00000X
- Additional Specialty
- Family Medicine
- Additional Specialty
- Family Medicine
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.