Individual provider · Type 1 NPI

Derrell Glenn Jackson, PA-C

Physician Assistant · Colonial Heights, VA

NPI number 1104072297 Active

Practice location

436 Claremont Ct, Suite 100
Colonial Heights, VA 23834-1765

Call (804) 526-2121 Map

Fax (804) 520-2617

Mailing address

205 Misty Ridge Ln
Suffolk, VA 23434-1516

Specialties and licenses

TaxonomyCodeLicense
Medical Physician Assistant 363AM0700X0110002804 (VA)
Physician Assistant Primary 363A00000X0110002804 (VA)

Physician Assistant: A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, orde…

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About NPI 1104072297

Derrell Glenn Jackson, PA-C's National Provider Identifier is 1104072297, issued on Aug 8, 2008. The primary taxonomy on file is Physician Assistant (363A00000X), and the practice location is in Colonial Heights, VA. The record was last updated on May 26, 2010.