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Clinton Jackson
NPI 1659675361 · on the registry since 2011 · sole proprietor
Practice
- Address
- 12244 Breckenridge Dr
Eagle River, AK 99577 - Phone
- (907) 694-6161
Registry record
- Primary taxonomy
- 237700000X
237700000X
- Licence states on file
- AK
From the registry's licence fields, which are often incomplete.
- Sex
- Male
- Record last updated
- 2019-07-01
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 Alaska