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Johnny Jackson
NPI 1336929884 · on the registry since 2023 · sole proprietor
Practice
- Address
- 6570 Sosna Dr
Fairfield, OH 45014 - Phone
- (513) 942-4673
- Fax
- (513) 860-1439
- Clinicians at this address
- 96
Registry record
- Primary taxonomy
- 175T00000X
175T00000X
- Also registered as
- 171M00000X
- Licence states on file
- OH
From the registry's licence fields, which are often incomplete.
- Sex
- Male
- Record last updated
- 2023-11-16
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 Ohio