Brian Jackson, PAC

NPI 1245261064 · on the registry since 2006

Practice

Address: 509 Main Street
La Jara, CO 81140
Phone: (719) 376-2308
Fax: (719) 376-2395
Organisation at this address: Conejos County Hospital Corporation
Lutheran Hospital Association Of The San Luis Valley
Inferred from a shared address, not stated in the registry.
Clinicians at this address: 2

Registry record

Primary taxonomy: 363A00000X
363A00000X
Licence states on file: CO
From the registry's licence fields, which are often incomplete.
Sex: Male
Record last updated: 2021-05-06

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 Colorado