Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
RUSSELL EMANUEL JACKSON, AT
ActiveRUSSELL EMANUEL JACKSON, AT is a Athletic Trainer healthcare provider located in GOLDSBORO, North Carolina. NPI 1932622867 is currently active in the NPPES registry. Verify at CMS.
Athletic Trainer · GOLDSBORO, NC
Registration Details
- NPI Number
- 1932622867
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Jul 23, 2017 (9.0246428649587 yrs)
- Last Updated
- Aug 3, 2021
- License
-
AT0005240 (OH)
Practice Information
- Address
-
406 SHERIDAN FOREST RDGOLDSBORO, NC, 275347103Browse NC providers · Browse ZIP 27534
- Phone
- 4192158888
- Primary Specialty
-
Athletic Trainer
2255A2300X
Other Athletic Trainer Providers in GOLDSBORO, NC
| Name | Credential | NPI |
|---|---|---|
| KAITLIN ROSE GRIEGO | LAT, ATC | 1386069086 |
| IMANN ROLLINS | MS, ATC | 1265883862 |
| SAMANTHA PAIZS | — | 1780128009 |
| MR. WALTER EDWARD BROSSEAU | — | 1447899380 |
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.