Individual
CHRISTOPHER H JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
6356 NYS ROUTE 30, INDIAN LAKE, NY 12842-2021
(518) 648-5707
(518) 648-6160
Mailing address
9 CAREY RD, QUEENSBURY, NY 12804-7880
(518) 761-0300
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
006846
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02346647
—
NY
Enumeration date
08/31/2006
Last updated
12/29/2025
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