Individual provider · Type 1 NPI

Timothy Lawrence Jackson, PA

Medical Physician Assistant · Williams, AZ

NPI number 1124338504 Active

Practice location

300 S 6th St
Williams, AZ 86046-0110

Mailing address

PO Box 3630
Flagstaff, AZ 86003-3630

Other practice locations

  • 2722 N Mariah Way, Flagstaff, AZ 86004-7550 · (928) 527-7759

Specialties and licenses

TaxonomyCodeLicense
Medical Physician Assistant Primary 363AM0700X5407 (AZ)

Medical Physician Assistant: Definition to come...

23 other providers at this address

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About NPI 1124338504

Timothy Lawrence Jackson, PA's National Provider Identifier is 1124338504, issued on Oct 19, 2010. The primary taxonomy on file is Medical Physician Assistant (363AM0700X), and the practice location is in Williams, AZ. The record was last updated on Jul 21, 2021.