Individual
DR. WARREN JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
656 ROOSEVELT TRL, WINDHAM, ME 04062-5271
(207) 389-3525
Mailing address
656 ROOSEVELT TRL, WINDHAM, ME 04062-5271
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OPT1120
ME
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
04/13/2026
Last updated
06/14/2026
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