Dr Jerry S Jackson & Associates P a
NPI #1235235136 in Leavenworth, Kansas
Provider Information
- NPI Number
- 1235235136
- Entity Type
- Organization
- Organization Name
- Dr Jerry S Jackson & Associates P a
- Primary Specialty
- Clinic/Center - Podiatric
- Enumeration Date
- Sep 16, 2006
- Last Updated
- Jun 26, 2013
Practice Location
- Address
- 113 DELAWARE ST
- Address 2
- SUITE D
- City
- Leavenworth
- State
- Kansas
- ZIP Code
- 66048-2822
- Phone
- (913) 682-4335
Authorized Official
- Name
- DR. JERRY STEPHEN JACKSON, DPM
- Title
- PRESIDENT
- Phone
- (913) 682-4335
Specialties & Taxonomy Codes
| Specialty |
|---|
| Clinic/Center - Podiatric — Podiatric |
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