Individual
DONALD J. JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
185 GRAFTON RD., TOWNSHEND, VT 05353
(802) 365-4331
Mailing address
PO BOX 216, 185 GRAFTON RD., TOWNSHEND, VT 05353-0216
(802) 365-4331
(802) 365-7031
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
055-0030673
VT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
OAP1167
—
VT
Enumeration date
09/27/2006
Last updated
07/09/2008
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