Robert Jackson

NPI #1174009039 in Nowata, Oklahoma

Provider Information

NPI Number: 1174009039
Entity Type: Individual
Name: Robert Jackson
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Peer Specialist
Enumeration Date: Jul 13, 2018
Last Updated: Aug 13, 2018

Practice Location

Address: 114 W DELAWARE AVE
City: Nowata
State: Oklahoma
ZIP Code: 74048
Phone: (918) 273-1841

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Peer Specialist	175T00000X	Primary

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