Russell Patrick Jackson
NPI #1699322578 in Casa Grande, Arizona
Provider Information
- NPI Number
- 1699322578
- Entity Type
- Individual
- Name
- Russell Patrick Jackson
- Gender
- Not Specified
- Sole Proprietor
- Yes
- Primary Specialty
- Physician Assistant - Medical
- Enumeration Date
- Aug 24, 2019
- Last Updated
- Sep 6, 2024
Practice Location
- Address
- 301 E COTTONWOOD LN STE 1&2
- City
- Casa Grande
- State
- Arizona
- ZIP Code
- 85122-2551
- Phone
- (602) 569-3999
Specialties & Taxonomy Codes
| Specialty |
|---|
| Student in an Organized Health Care Education/Training Program |
| Physician Assistant - Medical — Medical |
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