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Derrell Glenn Jackson, PA-C
Physician Assistant in Colonial Heights, Virginia
NPI 1104072297

Derrell Glenn Jackson is a Physician Assistant based in Suffolk, VA. Derrell Glenn Jackson practices in Colonial Heights, VA and has the professional credentials of PA-C. The NPI Number for Derrell Glenn Jackson is 1104072297 and holds a License No. 0110002804 (Virginia).

The current practice location address for Derrell Glenn Jackson is 436 Claremont Ct, Colonial Heights, VA and can be reached out via phone at 804-526-2121 and via fax at 804-520-2617.

Location: 436 Claremont Ct, Colonial Heights, VA, 23434-1516
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1104072297
Provider Name
Derrell Glenn Jackson
Credential
PA-C
Provider Entity Type
Individual
Gender
Male
Address
436 Claremont Ct, Colonial Heights, VA, 23434-1516
Phone Number
804-526-2121
Fax Number
804-520-2617
Provider Enumeration Date
08/08/2008
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
1104072297 05 VA
10040880P 01 VA OPTIMA
P00685057 01 VA RR MEDICARE
10040880P 01 VA SENTARA HEALTHCARE
institution
Provider Business Practice Location Address Details
Address
436 Claremont Ct
City
Colonial Heights
State
Virginia
Zip
23834-1765
Phone Number
804-526-2121
Fax Number
804-520-2617
person
Provider Business Mailing Address Details
Address
436 Claremont Ct
City
Colonial Heights
State
Virginia
Zip
23834-1765
Phone Number
804-526-2121
Fax Number
804-520-2617
person
Provider's Taxonomy Details 1
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Physician Assistant
Speciality
-
Taxonomy
363A00000X
License No.
0110002804 (Virginia)
Definition
A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.
person
Provider's Taxonomy Details 2
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Physician Assistant
Speciality
Medical
Taxonomy
363AM0700X
License No.
0110002804 (Virginia)
Definition
Definition to come...
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