Randy D Jackson, PA-C

NPI #1508825357 in Millinocket, Maine

Provider Information

NPI Number: 1508825357
Entity Type: Individual
Name: Randy D Jackson, PA-C
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Physician Assistant
Credential: PA-C
Enumeration Date: Mar 21, 2006
Last Updated: Feb 11, 2013

Practice Location

Address: 200 SOMERSET ST
Address 2: SUITE 2
City: Millinocket
State: Maine
ZIP Code: 04462-1258
Phone: (207) 723-5173

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physician Assistant	363A00000X	Primary

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