Individual
DR. ROBERT ANDREW JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DPM
Contact information
Practice address
440 PELLIS RD, GREENSBURG, PA 15601-4529
(724) 853-9896
(724) 853-9897
Mailing address
440 PELLIS RD, GREENSBURG, PA 15601-4529
(724) 853-9896
(724) 853-9897
Taxonomy
Speciality
Code
Description
License number
State
213ES0131X
Foot Surgery Podiatrist
Primary
SC2741L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01676810/01
—
PA
01
—
JA863061
BLUE SHIELD
PA
Enumeration date
01/11/2006
Last updated
07/20/2007
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