IndividualActive
John Jackson, PA-C
NPI 1295792687 · Medical Physician Assistant · Newport, RI
Provider details
- NPI number
- 1295792687
- Entity type
- Individual
- Primary specialty
- Medical Physician AssistantPhysician Assistants & Advanced Practice Nursing Providers
- Credential
- PA-C
- Sex
- Male
- Sole proprietor
- No
- License
- PA00132 (RI)
Specialties & taxonomies
Physician Assistants & Advanced Practice Nursing Providers
Practice location
11 Friendship St
Newport, RI 02840-2271
Phone: (401) 845-1593
Fax: (401) 847-0650
Approximate (ZIP-level) locationGet directions
Mailing address
11 Friendship St
Newport, RI 02840-2271
Registry dates
- Enumerated
- 2006-04-28
- Last updated
- 2009-04-10
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.