Organization · Type 2 NPI
Kelly Jackson
Surgical Physician Assistant · Scottsdale, AZ
NPI number
1831582204
Active
Practice location
9345 E Voltaire Ave
Scottsdale, AZ 85260-7432
Fax (214) 764-0880
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Surgical Physician Assistant Primary | 363AS0400X | AP4200 (AZ) |
Surgical Physician Assistant: Definition to come...
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About NPI 1831582204
Kelly Jackson's National Provider Identifier is 1831582204, issued on Mar 10, 2015. The primary taxonomy on file is Surgical Physician Assistant (363AS0400X), and the practice location is in Scottsdale, AZ. The record was last updated on Mar 10, 2015.