Individual
TREVOR G JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
231 GRANITE RUN DRIVE, LANCASTER, PA 17601-6823
(717) 560-4200
(717) 560-4200
Mailing address
231 GRANITE RUN DRIVE, LANCASTER, PA 17601-6823
(717) 560-4200
(717) 560-4200
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
MD475250
PA
207XS0106X
Orthopaedic Hand Surgery Physician
Primary
MD475250
PA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/23/2015
Last updated
10/02/2024
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