Search › Arizona › 253J00000X
Jerome Jackson
NPI 1740815497 · on the registry since 2020 · sole proprietor
Practice
- Address
- 9680 W Northern Ave Unit 2311
Peoria, AZ 85345 - Phone
- (989) 980-8286
- Fax
- (602) 455-4626
- Clinicians at this address
- 3
Registry record
- Primary taxonomy
- 253J00000X
253J00000X
- Also registered as
- 385HR2055X
- Licence states on file
- AZ
From the registry's licence fields, which are often incomplete.
- Sex
- Male
- Record last updated
- 2020-03-03
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