Individual provider · Type 1 NPI

Randy H. Jackson, PA

Medical Physician Assistant · Gainesville, GA

NPI number 1629010707 Active

Practice location

743 Spring St NE
Gainesville, GA 30501-3715

Call (770) 536-2146 Map

Fax (770) 536-7895

Mailing address

PO Box 2938
Gainesville, GA 30503-2938

Specialties and licenses

TaxonomyCodeLicense
Medical Physician Assistant Primary 363AM0700X002048 (GA)

Medical Physician Assistant: Definition to come...

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About NPI 1629010707

Randy H. Jackson, PA's National Provider Identifier is 1629010707, issued on Jun 12, 2006. The primary taxonomy on file is Medical Physician Assistant (363AM0700X), and the practice location is in Gainesville, GA. The record was last updated on Nov 7, 2007.