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Search › Virginia › 183500000X

Jackson Kicklighter, PHARMD, MHA, BCMTMS

NPI 1255948345 · on the registry since 2020

Practice

Address
20 W Bank St Ste 6
Petersburg, VA 23803
Phone
(804) 835-5425
Organisation at this address
D19crisis
Genoa Healthcare Llc
District 19 Community Services Board
District 19 Community Services Board
Inferred from a shared address, not stated in the registry.
Clinicians at this address
56

Registry record

Primary taxonomy
183500000X
183500000X
Also registered as
183500000X
Licence states on file
NC, VA
From the registry's licence fields, which are often incomplete.
Sex
Male
Record last updated
2022-10-21

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