Kevin Jackson, DO

NPI #1104381573 in Atlanta, Georgia

Provider Information

NPI Number: 1104381573
Entity Type: Individual
Name: Kevin Jackson, DO
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Ophthalmology
Credential: DO
Enumeration Date: Feb 9, 2019
Last Updated: Sep 20, 2023

Practice Location

Address: 800 MOUNT VERNON HWY NE STE 130
City: Atlanta
State: Georgia
ZIP Code: 30328-4293
Phone: (404) 256-1125

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Student in an Organized Health Care Education/Training Program	390200000X
Ophthalmology	207W00000X	Primary

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