Individual
DR. JEFFREY ALAN JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
560 N CAMINO MERCADO STE 1, CASA GRANDE, AZ 85122-5759
(520) 426-9224
(520) 426-1554
Mailing address
4800 N 22ND ST STE 210, PHOENIX, AZ 85016-4963
(480) 892-8400
(602) 508-4830
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
1578
AZ
152W00000X
Optometrist
Primary
OPT-001578
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
161292
—
AZ
Enumeration date
07/10/2007
Last updated
11/17/2021
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