MR. KARIS LAVON JACKSON SR.
NPI 1073887808
Specialist/Technologist, Other - Electroneurodiagnostic in Tulsa, OK
Active since February 24, 2012
About Mr. Karis Lavon Jackson Sr. NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
MR. KARIS LAVON JACKSON SR. (NPI 1073887808) is an individual electroneurodiagnostic provider in Tulsa, Oklahoma, licensed in Oklahoma (1194001412) and active in the NPI registry since February 2012.
NPPES Registry Identity
NPI1073887808
Entity TypeIndividualMale
Primary Taxonomy246ZE0600X
Provider Legal NameMR. KARIS LAVON JACKSON SR.
Location Address218 S 182ND EAST AVETulsa, OK 74108-2133
Mailing Address218 S 182nd East AveTulsa, OK 74108-2133 · (918) 691-8579
Phone(918) 691-8579
Sole ProprietorYes
Enumeration DateFebruary 24, 2012
✔ NPI 1073887808 is a valid, active identifier and passes the ISO check-digit test.
Specialties & Licenses
★ Primary SpecialtySpecialist/Technologist, Other · ElectroneurodiagnosticTechnologists, Technicians & Other Technical Service Providers
Taxonomy Code246ZE0600X
License✔ Licensed in OK · 1194001412
218 S 182ND EAST AVE, Tulsa, OK 74108
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1073887808, enumerated as an "individual" on February 24, 2012.
The provider is located at 218 S 182ND EAST AVE TULSA, OK 74108 and the phone number is (918) 691-8579.
Specialist/Technologist, Other with taxonomy code 246ZE0600X and a focus in Electroneurodiagnostic.
