Individual provider · Type 1 NPI

Charles D. Jackson

Driver · Cleveland, OH

NPI number 1043655681 Active

Practice location

4856 W.12TH, Suite 1
Cleveland, OH 44109-3424

Call (440) 749-3019 Map

Mailing address

4856 W 12th St
Cleveland, OH 44109-5611

Specialties and licenses

TaxonomyCodeLicense
Driver Primary 172A00000XRS884250 (OH)

Driver: A person employed to operate a motor vehicle as a carrier of persons or property.

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About NPI 1043655681

Charles D. Jackson's National Provider Identifier is 1043655681, issued on May 9, 2013. The primary taxonomy on file is Driver (172A00000X), and the practice location is in Cleveland, OH. The record was last updated on Nov 22, 2013.