IndividualActive
J Jackson, D.O.
NPI 1942262399 · Addiction Medicine (Internal Medicine) Physician · Mesa, AZ
Provider details
- NPI number
- 1942262399
- Entity type
- Individual
- Primary specialty
- Addiction Medicine (Internal Medicine) PhysicianAllopathic & Osteopathic Physicians
- Credential
- D.O.
- Sex
- Male
- Sole proprietor
- No
- License
- 2543 (AZ)
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Allopathic & Osteopathic Physicians
Practice location
303 N Centennial Way
Mesa, AZ 85201-6733
Phone: (480) 649-3111
Fax: (480) 649-3113
Approximate (ZIP-level) locationGet directions
Mailing address
303 N Centennial Way
Mesa, AZ 85201-6733
Registry dates
- Enumerated
- 2006-04-03
- Last updated
- 2023-02-02
- Certified
- 2023-02-02
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.