Organization · Type 2 NPI
DR Jerry S Jackson & Associates P A
Podiatric Clinic/Center · Leavenworth, KS
NPI number
1235235136
Active
Practice location
113 Delaware St, Suite D
Leavenworth, KS 66048-2822
Fax (913) 682-2985
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Podiatric Clinic/Center Primary | 261QP1100X | 145 (KS) |
Podiatric Clinic/Center: Definition to come...
3 other providers at this address
About NPI 1235235136
DR Jerry S Jackson & Associates P A's National Provider Identifier is 1235235136, issued on Sep 16, 2006. The primary taxonomy on file is Podiatric Clinic/Center (261QP1100X), and the practice location is in Leavenworth, KS. The record was last updated on Jun 26, 2013.