Mr. David M. Jackson PA-C
Medical Physician Assistant in Orange City, FL(View on Map)
Full Name
Mr. David M Jackson PA-C
NPI Number
1952338485
NPI Type
Individual Provider
Gender
Male
Enumeration Date
06/28/2006
Specialties
(Taxonomies)Licenses
State
Florida
Virginia
License Number
9104510
01108408409
Contact
Information
Purpose
Mailing
Location
Address
2223 ASTOR ST
1133 SAXON BLVD
City
Orange Park
Orange City
State
FL
FL
Postal Code
32073-5668
32763-0000
Country
US
US
Telephone Number
(904) 305-3221
(904) 305-3221
Identifiers
Identifier
003373900
Y06YY
Identifier State
FL
Unknown
Identifier Issuer
Unknown
BCBS
Provider data last refreshed from NPPES NPI registry on 11/19/2024
Data last updated by provider on 08/01/2012
Provider Address
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