Individual
SUSANNAH ROSE JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
4000 JOHNSON RD, STEUBENVILLE, OH 43952-2364
(740) 264-8039
(740) 264-8049
Mailing address
380 SUMMIT AVENUE, MSO PHYSICIAN BILLING, STEUBENVILLE, OH 43952-2667
(740) 428-3175
(740) 283-7807
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
50.008544RX
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0035572
—
OH
Enumeration date
11/16/2021
Last updated
02/20/2024
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