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Randy H Jackson, PA
Medical Physician Assistant in Gainesville, Georgia
NPI 1629010707

Randy H Jackson is a Medical Physician Assistant based in Gainesville, GA and is specialized in Medical. Randy H Jackson practices in Gainesville, GA and has the professional credentials of PA. The NPI Number for Randy H Jackson is 1629010707 and holds a License No. 002048 (Georgia).

The current practice location address for Randy H Jackson is 743 Spring St Ne, Gainesville, GA and can be reached out via phone at 770-536-2146 and via fax at 770-536-7895. You can also correspond with Randy H Jackson through the mailing address at PO BOX 2938, GAINESVILLE, GA - 30503-2938 (mailing address contact number: 770-536-2146).

Location: 743 Spring St Ne, Gainesville, GA, 30503-2938
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Provider Profile Details
NPI Number
1629010707
Provider Name
Randy H Jackson
Credential
PA
Provider Entity Type
Individual
Gender
Male
Address
743 Spring St Ne, Gainesville, GA, 30503-2938
Phone Number
770-536-2146
Fax Number
770-536-7895
Provider Enumeration Date
06/12/2006
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
624253146A 05 GA
institution
Provider Business Practice Location Address Details
Address
743 Spring St Ne
City
State
Zip
30501-3715
Phone Number
770-536-2146
Fax Number
770-536-7895
person
Provider Business Mailing Address Details
Address
743 Spring St Ne
City
State
Zip
30501-3715
Phone Number
770-536-2146
Fax Number
770-536-7895
person
Provider's Taxonomy Details 1
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Physician Assistant
Speciality
Medical
Taxonomy
License No.
002048 (Georgia)
Definition
Definition to come...
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