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Contact Information

JERMAL JACKSON, RRT
CORNER OF ROUTES N12 & N7
FORT DEFIANCE, AZ86504
 Phone: 928-729-8000
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Critical Care

2279C0205X
 

Neonatal/Pediatrics

2279P3900X
Indicates primary specialty

NPI Profile & details for JERMAL JACKSON · (Male)

NPI Number 1760115992
Status Active
Credentials RRT
Entity Individual
Enumeration date 07/06/2022
Last updated 07/06/2022 - About 4 years ago
Sole proprietor 1 Yes
Identifiers Not Available
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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