MR. Brian John Jackson, PA

NPI #1083198659 in Lehigh Acres, Florida

Provider Information

NPI Number: 1083198659
Entity Type: Individual
Name: MR. Brian John Jackson, PA
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Physician Assistant
Credential: PA
Enumeration Date: Sep 19, 2018
Last Updated: Mar 14, 2019

Practice Location

Address: 391 LEE BLVD STE 300
City: Lehigh Acres
State: Florida
ZIP Code: 33936-4973
Phone: (239) 369-4088

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physician Assistant	363A00000X	Primary

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