Individual
KEVIN MICHAEL JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
4494 PALMER RD N, BETHESDA, MD 20814
(301) 295-3016
Mailing address
4301 JONES BRIDGE RD, BETHESDA, MD 20814-4712
(301) 295-3016
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
T006010
NY
Other
Enumeration date
10/25/2005
Last updated
11/06/2025
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