Individual
DAVID A. JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
NAVAJO ROUTE 4, PINON HEALTH CENTER, PINON, AZ 86510
(928) 725-9500
Mailing address
PO BOX 10, PINON, AZ 86510-0010
(928) 725-9500
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
35.099840
OH
208000000X
Pediatrics Physician
35.099840
OH
Other
Enumeration date
04/23/2009
Last updated
01/08/2014
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