Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days.
Individual
RANDY D JACKSON
Active
Individual
RANDY D JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA-028
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
079032
ANTHEM
ME
05
—
1508825357
—
ME
01
—
201855
NGS
ME
Enumeration date
03/21/2006
Last updated
02/11/2013
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Sign upProduct
Developers