Individual provider · Type 1 NPI
Hazel Jackson, PA-C
Medical Physician Assistant · Gloucester, VA
NPI number
1457684284
Active
Practice location
7502 Justice Dr
Gloucester, VA 23061-6101
Fax (804) 693-1093
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Medical Physician Assistant Primary | 363AM0700X | 0110002755 (VA) |
Medical Physician Assistant: Definition to come...
Other medical physician assistant providers in Gloucester
About NPI 1457684284
Hazel Jackson, PA-C's National Provider Identifier is 1457684284, issued on Sep 11, 2009. The primary taxonomy on file is Medical Physician Assistant (363AM0700X), and the practice location is in Gloucester, VA. The record was last updated on Sep 11, 2009.