Brian Gene Jackson, PAC

NPI #1245261064 in La Jara, Colorado

Provider Information

NPI Number: 1245261064
Entity Type: Individual
Name: Brian Gene Jackson, PAC
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Physician Assistant
Credential: PAC
Enumeration Date: Jul 6, 2006
Last Updated: May 6, 2021

Practice Location

Address: 509 MAIN STREET
City: La Jara
State: Colorado
ZIP Code: 81140
Phone: (719) 376-2308

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physician Assistant	363A00000X	Primary

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