NPI 1619720935

Russell Jackson

Practitioner Transportation Network Company Jacksonville, FL

Practice location

Address: 2433 Adams Lake Blvd, Jacksonville, FL 32221-2832
Phone: (318) 404-9501

Registered specialties

Transportation Network Company Primary

Transportation Services Taxonomy 342000000X Licence J2507244020 (FL)

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Registry record

NPI: 1619720935
Entity type: Individual
Sex (as registered): Male
NPI issued: 8 Apr 2024
Record last updated: 8 Apr 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.