Koree Mathew Jackson

Driver · Jay, OK

Individual Active NPI

NPI number 1679395313

Practice location

32426 S 554 Loop
Jay, OK 74346
Phone
(417) 680-4587

Open in Google Maps

NPI record

NPI
1679395313
Entity type
Individual (Type 1)
Enumeration date
October 24, 2024
Last updated
October 24, 2024
Certified
October 22, 2024
Sole proprietor
No

Specialties & taxonomy codes

TaxonomyCodeLicenseState
Driver Primary 172A00000X S084009464 OK

About Koree Jackson

Koree Mathew Jackson is a healthcare provider registered in the NPI registry with the primary taxonomy Driver (code 172A00000X). The practice location is 32426 S 554 Loop, Jay, OK 74346. The NPI number 1679395313 was assigned on October 24, 2024 and the record was last updated on October 24, 2024.

Koree Jackson lists a license in the registry: #S084009464 (OK) for Driver. License numbers are self-reported to NPPES; verify them with the state licensing board.

Frequently asked questions

What is the NPI number of Koree Mathew Jackson?

The NPI number is 1679395313.

What is the phone number of Koree Jackson?

The phone number listed for the practice location is (417) 680-4587.

Where is Koree Jackson located?

32426 S 554 Loop, Jay, OK 74346.

What is the taxonomy code for Koree Jackson?

The primary taxonomy code is 172A00000X – Driver.

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.