Organization
JACKSON EYE CARE, INC
Active
Other names
BARRY JACKSON OD
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RUSSELL B JACKSON OD (OWNER OPERATOR)
(435) 586-1500
Entity
Organization
Contact information
Practice address
51 E 400 N, SUITE 4A, CEDAR CITY, UT 84720-2686
(435) 586-1500
(435) 865-0784
Mailing address
PO BOX 1574, CEDAR CITY, UT 84721-1574
(435) 586-1500
(435) 865-0784
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
375344-9934
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
528882505001
—
UT
Enumeration date
12/05/2007
Last updated
02/11/2008
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