Individual
JODI JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
8791 BARNES LAKE RD, STE 202, IRWIN, PA 15642-3176
(724) 864-6834
Mailing address
11279 PERRY HWY, STE 450, WEXFORD, PA 15090-9303
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
MD419732
PA
Other
Enumeration date
05/24/2005
Last updated
03/25/2021
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