TREVIS SHANTELL JACKSON
NPI 1073321659
Physical Medicine & Rehabilitation in Fairburn, GA
About Trevis Shantell Jackson NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
TREVIS SHANTELL JACKSON (NPI 1073321659) is an individual physical medicine & rehabilitation provider in Fairburn, Georgia, licensed in Georgia (OTA000749) and active in the NPI registry since December 2024.
NPPES Registry Identity
Specialties & Licenses 2
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Trevis Jackson's NPI number?
The NPI number for Trevis Jackson is 1073321659. It was assigned to this individual provider in the NPPES registry on December 27, 2024.
Where is Trevis Jackson located?
Trevis Jackson practices at 7420 Mistydawn Dr, Fairburn, GA 30213. The listed phone number is (678) 361-8944.
What is Trevis Jackson's specialty?
The primary specialty registered for this NPI is Physical Medicine & Rehabilitation with taxonomy code 208100000X.
When was this NPI record last updated?
The NPPES record for Trevis Jackson was last updated on December 27, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.