Individual
JACKSON MACDONALD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
575 COPELAND MILL RD STE 1D, WESTERVILLE, OH 43081-8977
(614) 794-0481
Mailing address
4103 BERRYBUSH DR, COLUMBUS, OH 43230-5108
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
50.007418RX
OH
Other
Enumeration date
01/25/2022
Last updated
01/25/2022
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