IndividualActive
Alfred Vaughn Jackson, MD
NPI 1891746707 · Family Medicine Physician · La Jara, CO
Provider details
- NPI number
- 1891746707
- Entity type
- Individual
- Primary specialty
- Family Medicine PhysicianAllopathic & Osteopathic Physicians
- Credential
- MD
- Sex
- Male
- Sole proprietor
- Yes
- License
- 1823241205 (UT)
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Allopathic & Osteopathic Physicians
Allopathic & Osteopathic Physicians
Practice location
416 Main Street
La Jara, CO 81140-0272
Phone: (719) 274-4500
Fax: (719) 274-4504
Approximate (ZIP-level) locationGet directions
Mailing address
Po Box 272
La Jara, CO 81140-0272
Registry dates
- Enumerated
- 2006-05-15
- Last updated
- 2013-11-13
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.