NPI 1962119867
Derrick Jackson
Practice location
- Address
- 11000 Delaware Pkwy APT 2307, Kansas City, KS 66109-3567
- Phone
- (913) 908-0397
- Mailing address
- PO Box 25562, Kansas City, MO 64119-0862
Registered specialties
Driver
Primary
Registry record
- NPI
- 1962119867
- Entity type
- Individual
- Sex (as registered)
- Male
- NPI issued
- 31 Oct 2022
- Record last updated
- 1 Nov 2022
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.