DR. Ricky Jackson

NPI #1164161030 in Memphis, Tennessee

Provider Information

NPI Number: 1164161030
Entity Type: Individual
Name: DR. Ricky Jackson
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Private Vehicle
Enumeration Date: May 31, 2022
Last Updated: May 31, 2022

Practice Location

Address: 7443 KEYNON CV
City: Memphis
State: Tennessee
ZIP Code: 38125-2737
Phone: (919) 559-4876

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Non-emergency Medical Transport (VAN)	343900000X
Private Vehicle	347C00000X	Primary

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