Individual
MATTHAN JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
240 ALLEGHENY HWY, ELKINS, WV 26241-5749
(304) 636-0133
Mailing address
240 ALLEGHENY HWY, ELKINS, WV 26241-5749
(304) 636-0133
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
3347
WV
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
05/04/2016
Last updated
09/10/2025
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