Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
MR. ROBERT WALLACE JACKSON JR.
Active Sole ProprietorMR. ROBERT WALLACE JACKSON JR. is a In Home Supportive Care Agency healthcare provider located in MARIETTA, Georgia. NPI 1932791993 is currently active in the NPPES registry. Verify at CMS.
In Home Supportive Care Agency · MARIETTA, GA
Registration Details
- NPI Number
- 1932791993
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Feb 10, 2021 (5.5403156726836 yrs)
- Last Updated
- Feb 10, 2021
- License
-
PHCP010932 (GA)
- Sole Proprietor
- Yes
Practice Information
- Address
-
1355 TERRELL MILL RD SE BLDG 1462-125MARIETTA, GA, 300675559Browse GA providers · Browse ZIP 30067
- Phone
- 4706327400
- Fax
- 4705240500
- Primary Specialty
-
In Home Supportive Care Agency
253Z00000X
Other In Home Supportive Care Agency Providers in MARIETTA, GA
| Name | Credential | NPI |
|---|---|---|
| ROBIN BREAULT | — | 1912500794 |
| TYRONE MCCOY | — | 1316795578 |
| MS. MILKAH W MUTHONI | RN | 1558196758 |
| MARIA IGOCHE | — | 1063226876 |
| CHRISTINA ANDREWS | — | 1780563031 |
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.