NPI 1255203469

Richard Thomas Jackson, CSFA

Practitioner Surgical Assistant Elizabethtown, KY

Practice location

Address: 913 N Dixie Ave, Elizabethtown, KY 42701-2503
Phone: (270) 706-1380
Mailing address: 365 Loretto Dr # Dt, Elizabethtown, KY 42701-4715

Registered specialties

Surgical Assistant Primary

Technologists, Technicians & Other Technical Service Providers Taxonomy 246ZC0007X

Other Specialist/Technologist, Other providers in Kentucky →

Registry record

NPI: 1255203469
Entity type: Individual
Sex (as registered): Male
NPI issued: 18 Sep 2025
Record last updated: 24 Oct 2025

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.