| NPI | 1235235136 |
|---|---|
| Doing Business As | DR JERRY S JACKSON AND ASSOCIATES P A |
| Entity Type | Organization |
| Authorized Contact | JERRY STEPHEN JACKSON President 913-682-4335 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP1100X Clinic/Center, Podiatric (Licence: KS 145) |
| Enumeration Date | 2006-09-16 |
| Last Update Date | 2013-06-26 |