KELLY JACKSON
NPI 1831582204
Physician Assistant - Surgical in Scottsdale, AZ
- Organization
- Physician Assistant
- Surgical
About KELLY JACKSON
This page provides the complete NPI Profile along with additional information for Kelly Jackson, a provider established in Scottsdale, Arizona operating as a Physician Assistant, focusing in surgical . The healthcare provider is registered in the NPI registry with number 1831582204 assigned on March 2015. The practitioner's primary taxonomy code is 363AS0400X with license number AP4200 (AZ). The provider is registered as an organization and their NPI record was last updated 11 years ago. Kelly Jackson operates as a Multi-Specialty Group with one or more individual practitioners, who practice different areas of specialization. The authorized official of this NPI record is Kelly Jackson Np (Owner)
- NPI
- 1831582204 Verify this NPI
- Provider Name
- KELLY JACKSON
- Entity Type
- Organization
- Location Address
- 9345 E VOLTAIRE AVE SCOTTSDALE, AZ 85260
- Location Phone
- (214) 227-2457
- Location Fax
- (214) 764-0880
- Mailing Address
- 9345 E VOLTAIRE AVE SCOTTSDALE, AZ 85260
- Mailing Phone
- (214) 227-2457
- Mailing Fax
- (214) 764-0880
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 03-10-2015
- Last Update Date
- 03-10-2015
- Code Navigator
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Physician Assistant Surgical
- Taxonomy Code
- 363AS0400X
- Type
- Physician Assistants & Advanced Practice Nursing Providers
- License No.
- AP4200
- License State
- AZ
Group Taxonomy 193200000X MULTI-SPECIALTY GROUP
This provider is a business group of one or more individual practitioners, who practice with different areas of specialization.
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Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1831582204, enumerated as an "organization" on March 10, 2015.
The provider is located at 9345 E VOLTAIRE AVE SCOTTSDALE, AZ 85260 and the phone number is (214) 227-2457.
Physician Assistant with taxonomy code 363AS0400X and a focus in Surgical.
