Individual
MR. KEVIN CARL JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OPTOMETRIST
Contact information
Practice address
7828 EASTERN AVE NW, WASHINGTON, DC 20012
(202) 829-2700
(202) 829-4033
Mailing address
7828 EASTERN AVE NW, WASHINGTON, DC 20012
(202) 829-2700
(202) 829-4033
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
615
DC
Other
Enumeration date
03/07/2007
Last updated
07/08/2007
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