Kenneth C Jackson in Warr Acres - Specialist
Kenneth C Jackson - NPI 1457491037
Kenneth C Jackson is a Specialist in Warr Acres, Oklahoma. Kenneth C Jackson practices all healthcare services and medical treatments related to Specialist. The NPI Number for Kenneth C Jackson is 1457491037. The last update date is 2023-03-07.
Kenneth C Jackson's current location address is 7301 N Comanche Ave, Warr Acres, Oklahoma. You can contact this provider via phone number 4057218090 and fax number 4057228529. The mailing address for Kenneth C Jackson is 7301 N Comanche Ave, Warr Acres, Oklahoma. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Kenneth C Jackson |
|---|---|
| Address | 7301 N Comanche Ave, Warr Acres, Oklahoma |
| Phone Number | 4057218090 |
| Fax Number | 4057228529 |
| Sole Proprietor | N |
| Credentials | M.D. |
NPI Number Detail
| NPI Number | 1457491037 |
|---|---|
| Provider Enumeration Date | 2007-02-06 |
| Last Updated Date | 2023-03-07 |
Provider Mailing Address Detail
| Address | 7301 N Comanche Ave |
|---|---|
| City | Warr Acres |
| State | Oklahoma (OK) |
| Post Code | 731326646 |
| Phone Number | 4057218090 |
| Fax Number | 4057228529 |
Provider's Primary Taxonomy Detail
| Speciality | Specialist |
|---|---|
| Taxonomy | 174400000X |
| Licence No | 11030 |
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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 |
|---|---|---|---|
| 11030 | OK | LICENSE |
Post Comment/ Review Below
What is the unique identifier code issued to Kenneth C Jackson by the Centers for Medicare & Medicaid Services?
The Kenneth C Jackson has been assigned the NPI (National Provider Identifier) 1457491037. This 10-digit code serves as a unique identification number for healthcare providers issued by the Centers for Medicare & Medicaid Services (CMS).
Could you provide the complete address where Kenneth C Jackson is physically located?
The Kenneth C Jackson is situated at the following address: 7301 N Comanche Ave, Warr Acres, OK 731326646.
What is Kenneth C Jackson's specialized field of practice, and what is the corresponding taxonomy code that categorizes this area of expertise?
The area of specialization for Kenneth C Jackson is Specialist, and the taxonomy code that classifies this field of practice is 174400000X.
On what date did the Kenneth C Jackson receive its 1457491037 assignment from the Centers for Medicare & Medicaid Services?
The Kenneth C Jackson was assigned its 1457491037 by the Centers for Medicare & Medicaid Services on 2007-02-06.
When was the information regarding Kenneth C Jackson most recently updated?
The details pertaining to the Kenneth C Jackson, including its address, specialty, and other relevant information, were last refreshed on 2023-03-07.