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KEVIN ANTHONY JACKSON
NPI 1427829548
Driver in Lake Havasu City, AZ

Active since January 09, 2024
2470 CONSTELLATION DR UNIT 103, LAKE HAVASU CITY, AZ 86403(310) 484-8432 Get Directions Write a Review

NPPES record last updated: January 9, 2024. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Kevin Anthony Jackson NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

KEVIN ANTHONY JACKSON (NPI 1427829548) is an individual driver provider in Lake Havasu City, Arizona, licensed in Arizona (D08566611) and active in the NPI registry since January 2024.

NPPES Registry Identity

NPI1427829548
Entity TypeIndividualMale
Primary Taxonomy172A00000X
Provider Legal NameKEVIN ANTHONY JACKSON
Location Address2470 CONSTELLATION DR UNIT 103Lake Havasu City, AZ 86403-4944
Mailing Address2470 Constellation Dr Unit 103Lake Havasu City, AZ 86403-4944 · (310) 484-8432
Phone(310) 484-8432
Sole ProprietorYes
Enumeration DateJanuary 9, 2024
NPPES CertifiedJanuary 9, 2024
✔ NPI 1427829548 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDriverOther Service Providers
Taxonomy Code172A00000X
License✔ Licensed in AZ · D08566611
Definition
A person employed to operate a motor vehicle as a carrier of persons or property.
2470 CONSTELLATION DR UNIT 103, Lake Havasu City, AZ 86403
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Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

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 Kevin Jackson's NPI number?

The NPI number for Kevin Jackson is 1427829548. It was assigned to this individual provider in the NPPES registry on January 9, 2024.

Where is Kevin Jackson located?

Kevin Jackson practices at 2470 Constellation Dr Unit 103, Lake Havasu City, AZ 86403. The listed phone number is (310) 484-8432.

What is Kevin Jackson's specialty?

The primary specialty registered for this NPI is Driver with taxonomy code 172A00000X.

When was this NPI record last updated?

The NPPES record for Kevin Jackson was last updated on January 9, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years 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.