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Individual

JACKSON PRESTWOOD

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
101 BODIN CIR BLDG 777, TRAVIS AFB, CA 94535-1809
(707) 423-3000
(707) 423-5055
Mailing address
101 BODIN CIR BLDG 777, TRAVIS AFB, CA 94535-1809
(707) 423-3000
(707) 423-5055

Taxonomy

Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
0101265195
VA
208D00000X
General Practice Physician
Primary
0101265195
VA

Other

Enumeration date
03/04/2017
Last updated
04/27/2026
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