Individual
DR. DERRICK O'NEAL JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPM
Contact information
Practice address
420 OAK HILL AVENUE, YOUNGSTOWN, OH 44502-1415
(330) 870-3900
(330) 870-3901
Mailing address
3255 E LIVINGSTON AVENUE, COLUMBUS, OH 43227-1967
(866) 953-3519
(614) 239-1080
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
30003456
OH
213ER0200X
Radiology Podiatrist
36003456
OH
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
36003456
OH
Other
Enumeration date
04/09/2007
Last updated
04/05/2022
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