CARL JACKSON

TULSA, OK
NPI1902263270
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy363A00000X Physician Assistant
(Licence: OK  PA 2616)
Enumeration Date2016-01-18
Last Update Date2016-01-18
Business Address
-- CARL JACKSON PA-C
8801 S 101ST EAST AVE
TULSA, OK 74133-5716
Phone number: 918-579-6090
Mailing Address
-- CARL JACKSON PA-C
22096 S 445TH EAST AVE
PORTER, OK 74454-3239
Phone number: 918-625-7927
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