Russell Jackson

NPI 1699322578 · on the registry since 2019 · sole proprietor

Practice

Address: 301 E Cottonwood Ln Ste 1&2
Casa Grande, AZ 85122
Phone: (602) 569-3999
Fax: (520) 340-4359
Organisation at this address: Center For Family Medicine Mdpc
Inferred from a shared address, not stated in the registry.
Clinicians at this address: 3

Registry record

Primary taxonomy: 363AM0700X
363AM0700X
Also registered as: 390200000X
Licence states on file: AZ
From the registry's licence fields, which are often incomplete.
Sex: Male
Record last updated: 2024-09-06

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 Arizona