Organization · Type 2 NPI
Vaughn D Jackson, PLLC
Medical Specialty Clinic/Center · La Jara, CO
Practice location
412 Main
La Jara, CO 81140
Fax (719) 274-4504
Mailing address
P.o. Box 272, 416 Main
La Jara, CO 81140
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Medical Specialty Clinic/Center Primary | 261QM2500X | 31351 (CO) |
Medical Specialty Clinic/Center: An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to a specific area of medical specialization. Frequently used for Title V related Children's Specialty services or to meet specific public health needs (e.g., infectious diseases or breast and cervical cancer).
About NPI 1710308952
Vaughn D Jackson, PLLC's National Provider Identifier is 1710308952, issued on Dec 13, 2013. The primary taxonomy on file is Medical Specialty Clinic/Center (261QM2500X), and the practice location is in La Jara, CO. The record was last updated on Dec 13, 2013.