Randy D Jackson, PA-C
Physician Assistant in Millinocket, Maine
1508825357- Practice location
- 200 Somerset St, Suite 2, Millinocket, ME 04462-1258
- Phone
- 207-723-5173
- Fax
- 207-723-3040
- Last updated
- February 11, 2013
Randy D Jackson is a Physician Assistant based in Millinocket, ME. Randy D Jackson practices in Millinocket, ME and has the professional credentials of PA-C. The NPI Number for Randy D Jackson is 1508825357 and holds a License No. PA-028 (ME). The current practice location address for Randy D Jackson is 200 Somerset St, Suite 2, Millinocket, ME 04462-1258 and can be reached out via phone at 207-723-5173 and via fax at 207-723-3040.
Provider Profile Details
- NPI Number
- 1508825357
- Provider Name
- Randy D Jackson
- Credential
- PA-C
- Provider Entity Type
- Individual
- Gender
- Male
- Address
- 200 Somerset St, Suite 2, Millinocket, ME 04462-1258
- Phone Number
- 207-723-5173
- Fax Number
- 207-723-3040
- Primary Taxonomy
- Physician Assistant · 363A00000X
- Sole Proprietor
- No
- Provider Enumeration Date
- March 21, 2006
- Last Update Date
- February 11, 2013
- NPI Status
- Active
Provider Business Practice Location Address Details
- Address
- 200 Somerset St
Suite 2
Millinocket, ME 04462-1258 - City
- Millinocket
- State
- Maine
- Zip
- 04462-1258
- Phone Number
- 207-723-5173
- Fax Number
- 207-723-3040
Provider Business Mailing Address Details
- Address
- 200 Somerset St
Millinocket, ME 04462-1258 - City
- Millinocket
- State
- ME
- Zip
- 04462-1258
- Phone Number
- 207-723-5173
- Fax Number
- 207-723-3040
License Information
- License Number
- PA-028
- License State
- ME
- Taxonomy
- Physician Assistant · 363A00000X · Primary
Legacy Identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| No legacy identifiers (Medicaid, Medicare or plan IDs) are on file for this provider. | |||
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Frequently Asked Questions
What is the NPI number of Randy D Jackson, PA-C?
The NPI number of Randy D Jackson, PA-C is 1508825357. It was assigned on March 21, 2006 and is currently active in the NPPES registry.
What is the specialty of Randy D Jackson, PA-C?
Randy D Jackson, PA-C is registered under the primary taxonomy Physician Assistant (code 363A00000X), licensed in ME under license number PA-028.
Where does Randy D Jackson, PA-C practice?
The practice location is 200 Somerset St, Suite 2, Millinocket, ME 04462-1258. The office can be reached at 207-723-5173 (phone) or 207-723-3040 (fax).
What is an NPI number?
A National Provider Identifier (NPI) is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS). It is used in HIPAA standard transactions.
How do I verify this NPI record?
This record is sourced from the public NPPES NPI Registry maintained by CMS. You can confirm it by searching NPI 1508825357 directly on the NPPES registry website.