Jackson Deen, PA

Physician Assistant · Gloucester, VA

Individual Active NPI

NPI number 1154891174

Practice location

7519 Hospital Dr
Gloucester, VA 23061-4178
Phone
(804) 693-8899
Fax
(804) 693-8810

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NPI record

NPI
1154891174
Entity type
Individual (Type 1)
Enumeration date
December 3, 2018
Last updated
December 3, 2018
Sole proprietor
Yes

Specialties & taxonomy codes

TaxonomyCodeLicenseState
Physician Assistant Primary 363A00000X — —

Mailing address

856 J Clyde Morris Blvd Ste a
Newport News, VA 23601-1318
Phone
(757) 316-5800
Fax
(757) 534-5190

About Jackson Deen

Jackson Deen, PA is a healthcare provider registered in the NPI registry with the primary taxonomy Physician Assistant (code 363A00000X). The practice location is 7519 Hospital Dr, Gloucester, VA 23061-4178. The NPI number 1154891174 was assigned on December 3, 2018 and the record was last updated on December 3, 2018.

Frequently asked questions

What is the NPI number of Jackson Deen, PA?

The NPI number is 1154891174.

What is the phone number of Jackson Deen?

The phone number listed for the practice location is (804) 693-8899.

Where is Jackson Deen located?

7519 Hospital Dr, Gloucester, VA 23061-4178.

What is the taxonomy code for Jackson Deen?

The primary taxonomy code is 363A00000X – Physician Assistant.

Is this information correct?

All details come from the public NPPES registry. Providers can update their record at nppes.cms.hhs.gov; changes appear here after the next weekly update.

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