Derrell Jackson, PA-C

NPI 1104072297 · on the registry since 2008

Practice

Address: 436 Claremont Ct
Suite 100
Colonial Heights, VA 23834
Phone: (804) 526-2121
Fax: (804) 520-2617
Organisation at this address: Petersburg Clinic Company, Llc
Petersburg Hospital Company Llc
Inferred from a shared address, not stated in the registry.
Clinicians at this address: 3

Registry record

Primary taxonomy: Physician Assistant
363A00000X
Also registered as: Medical Physician Assistant
Licence states on file: VA
From the registry's licence fields, which are often incomplete.
Sex: Male
Record last updated: 2010-05-26

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Virginia