NPI 1629479977

Sheldon Jackson

Practitioner Other Technician Fort Stewart, GA

Practice location

Address: 1061 Harmon Ave, Fort Stewart, GA 31314-5641
Phone: (912) 435-6042
Mailing address: 74 Canterbury Dr. NE, Ludowici, GA 31316

Registered specialties

Other Technician Primary

Technologists, Technicians & Other Technical Service Providers Taxonomy 247200000X

Other Technician, Other providers in Georgia →

Registry record

NPI: 1629479977
Entity type: Individual
Sex (as registered): Male
NPI issued: 5 Sep 2014
Record last updated: 5 Sep 2014

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.