Individual provider · Type 1 NPI

Derek C. Jackson, PA

Medical Physician Assistant · Orlando, FL

NPI number 1811979123 Active

Practice location

601 E Rollins St
Orlando, FL 32803-1248

Mailing address

500 Winderley Pl, Suite 115
Maitland, FL 32751-7247

Specialties and licenses

TaxonomyCodeLicense
Medical Physician Assistant Primary 363AM0700XPA9101356 (FL)

Medical Physician Assistant: Definition to come...

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About NPI 1811979123

Derek C. Jackson, PA's National Provider Identifier is 1811979123, issued on Nov 14, 2005. The primary taxonomy on file is Medical Physician Assistant (363AM0700X), and the practice location is in Orlando, FL. The record was last updated on Jul 8, 2007.