NPI 1144005745
Bradley Charles Jackson
Practice location
- Address
- 10178 Hwy 21, Ironton, MO 63650
- Phone
- (573) 330-2100
- Mailing address
- PO Box 510, Pilot Knob, MO 63663-0510
Registered specialties
Transportation Network Company
Primary
Registry record
- NPI
- 1144005745
- Entity type
- Individual
- Sex (as registered)
- Male
- NPI issued
- 30 Aug 2023
- Record last updated
- 30 Aug 2023
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.