Individual
AMY ELIZABETH JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA C
Contact information
Practice address
1124 MEDICAL PL, SEYMOUR, IN 47274-2640
(812) 522-1613
(812) 522-6694
Mailing address
1124 MEDICAL PL, SEYMOUR, IN 47274-2640
(812) 522-1613
(812) 522-6694
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
10000733A
IN
Other
Enumeration date
07/01/2005
Last updated
03/20/2013
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