Brock Jackson is a Specialist in Phoenix, Arizona. Brock Jackson practices all healthcare services and medical treatments related to Specialist. The NPI Number for Brock Jackson is 1821093667. The last update date is 2015-03-19.
Brock Jackson's current location address is 1661 E Camelback Rd, Phoenix, Arizona. You can contact this provider via phone number 6022411671 and fax number 6022746181. The mailing address for Brock Jackson is 1661 E Camelback Rd, Phoenix, Arizona. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Brock Jackson |
|---|---|
| Address | 1661 E Camelback Rd, Phoenix, Arizona |
| Phone Number | 6022411671 |
| Fax Number | 6022746181 |
| Sole Proprietor | N |
| Credentials | MD |
NPI Number Detail
| NPI Number | 1821093667 |
|---|---|
| Provider Enumeration Date | 2005-06-17 |
| Last Updated Date | 2015-03-19 |
Provider Mailing Address Detail
| Address | 1661 E Camelback Rd |
|---|---|
| City | Phoenix |
| State | Arizona (AZ) |
| Post Code | 8501639110 |
| Phone Number | 6022411671 |
| Fax Number | 6022746181 |
Provider's Primary Taxonomy Detail
| Speciality | Specialist |
|---|---|
| Taxonomy | 174400000X |
| Licence No | 32949 |
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Definition: An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 939902 | AZ | -- |
Post Comment/ Review Below
What is the unique 10-digit identifier code assigned to Brock Jackson by the Centers for Medicare & Medicaid Services?
The Brock Jackson has been issued the NPI (National Provider Identifier) 1821093667 by the CMS (Centers for Medicare & Medicaid Services), which serves as a unique identification number for healthcare providers.
Could you please provide the complete physical location address of Brock Jackson?
The Brock Jackson is physically situated at 1661 E Camelback Rd, in the city of Phoenix, state of AZ, with the postal code 8501639110.
What is Brock Jackson's area of expertise and its corresponding taxonomy classification?
The Brock Jackson's field of specialization is Specialist, and it falls under the taxonomy code 174400000X, which categorizes healthcare providers based on their areas of practice.
When did the Brock Jackson receive its 1821093667?
The Brock Jackson was issued its 1821093667 on 2005-06-17, which is the date when the organization was assigned this unique identifier.
As of what date was the information pertaining to Brock Jackson, such as address, specialty, and other details, last reviewed and confirmed to be accurate?
The information related to Brock Jackson, including its address, specialty, and other relevant details, was last reviewed and confirmed to be accurate on 2015-03-19.