DERRELL JACKSON, PA-C

Physician Assistant

Active Individual
NPI: 1104072297

Practice Address

436 CLAREMONT CT
SUITE 100
Colonial Heights, VA 23834

Phone: (804) 526-2121

Specialties

Specialty Code Primary License
Physician Assistant - Medical 363AM0700X No 0110002804 (VA)
Physician Assistant 363A00000X Yes 0110002804 (VA)

Frequently Asked Questions

NPI 1104072297 is the National Provider Identifier for DERRELL JACKSON, PA-C, a Physician Assistant provider located in Colonial Heights, VA. This NPI was enumerated on August 8, 2008.
DERRELL JACKSON, PA-C practices at 436 CLAREMONT CT, SUITE 100, Colonial Heights, VA 23834.

Quick Facts

NPI
1104072297
Type
Individual
Enumerated
Aug 8, 2008
Last Updated
May 26, 2010

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