NPI 1043062375

Isaiah William Jackson, MD

Practitioner Military Health Care Provider Portsmouth, VA

Practice location

Address: 620 John Paul Jones Cir, Portsmouth, VA 23708-2111
Phone: (757) 953-1814

Registered specialties (2)

Military Health Care Provider Primary

Other Service Providers Taxonomy 171000000X

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Student in an Organized Health Care Education/Training Program

Student, Health Care Taxonomy 390200000X

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Registry record

NPI: 1043062375
Entity type: Individual
Sex (as registered): Male
NPI issued: 2 Apr 2024
Record last updated: 11 Jun 2024

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.