Jackson Deen, PA
NPI #1154891174 in Gloucester, Virginia
Provider Information
- NPI Number
- 1154891174
- Entity Type
- Individual
- Name
- Jackson Deen, PA
- Gender
- Not Specified
- Sole Proprietor
- Yes
- Primary Specialty
- Physician Assistant
- Credential
- PA
- Enumeration Date
- Dec 3, 2018
- Last Updated
- Dec 3, 2018
Practice Location
- Address
- 7519 HOSPITAL DR
- City
- Gloucester
- State
- Virginia
- ZIP Code
- 23061-4178
- Phone
- (804) 693-8899
Specialties & Taxonomy Codes
| Specialty |
|---|
| Physician Assistant |
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