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1194587824
KENNETH WILLIAM JACKSON
CORBIN, KY
NPI
1194587824
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
363A00000X Physician Assistant
(Licence: KY TC075)
Enumeration Date
2024-01-29
Last Update Date
2024-10-11
Business Address
KENNETH WILLIAM JACKSON PA
2 TRILLIUM WAY STE 106
CORBIN, KY 40701-8426
Phone number: 606-526-4070
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Mailing Address
KENNETH WILLIAM JACKSON PA
2 TRILLIUM WAY STE 106
CORBIN, KY 40701-8426
Phone number: 606-526-4070
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