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1790357358
JACKSON D GANNON
OMAHA, NE
NPI
1790357358
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
363AS0400X Physician Assistant, Surgical
(Licence: NE 2632)
Enumeration Date
2021-07-13
Last Update Date
2021-07-13
Business Address
JACKSON D GANNON PA-C
8200 DODGE ST
OMAHA, NE 68114-4113
Phone number: 402-955-8600
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Mailing Address
JACKSON D GANNON PA-C
PO BOX 24607
OMAHA, NE 68124-0607
Phone number: 402-955-5400
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