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Kenneth C Jackson, MD
Specialist in Warr Acres, Oklahoma
NPI 1457491037

Kenneth C Jackson is a Specialist based in Warr Acres, OK. Kenneth C Jackson practices in Warr Acres, OK and has the professional credentials of MD. The NPI Number for Kenneth C Jackson is 1457491037 and holds a License No. 11030 (Oklahoma).

The current practice location address for Kenneth C Jackson is 7301 N Comanche Ave, Warr Acres, OK and can be reached out via phone at 405-721-8090 and via fax at 405-722-8529.

Location: 7301 N Comanche Ave, Warr Acres, OK, 73132-6646
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1457491037
Provider Name
Kenneth C Jackson
Credential
MD
Provider Entity Type
Individual
Gender
Male
Address
7301 N Comanche Ave, Warr Acres, OK, 73132-6646
Phone Number
405-721-8090
Fax Number
405-722-8529
Provider Enumeration Date
02/06/2007
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
11030 01 OK LICENSE
institution
Provider Business Practice Location Address Details
Address
7301 N Comanche Ave
City
Warr Acres
State
Oklahoma
Zip
73132-6646
Phone Number
405-721-8090
Fax Number
405-722-8529
person
Provider Business Mailing Address Details
Address
7301 N Comanche Ave
City
Warr Acres
State
Oklahoma
Zip
73132-6646
Phone Number
405-721-8090
Fax Number
405-722-8529
person
Provider's Taxonomy Details 1
Type
Other Service Providers
Classification
Specialist
Speciality
-
Taxonomy
174400000X
License No.
11030 (Oklahoma)
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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