Individual
TREVOR JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
1208 LANGHORNE NEWTOWN RD, LANGHORNE, PA 19047-1234
(267) 560-1100
Mailing address
1776 WOODSTEAD CT STE 208, THE WOODLANDS, TX 77380-1480
(877) 749-7428
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
OS025148
PA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
104520988-0001
—
PA
05
—
104520988-0002
—
PA
Enumeration date
04/27/2021
Last updated
12/15/2025
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