Randy Jackson is a student in an organized health care education training program in Saint Louis, MO with 7 years of experience. The provider is an individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. Randy Jackson NPI is 1437681301. The provider is registered as an individual entity type.
The NPPES NPI record indicates the provider is a male.
The provider's business location address is:
6420 CLAYTON RD
ROOM 2234
SAINT LOUIS, MO
ZIP 63117-811
Phone: (314) 951-7240
The NPI 1437681301 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.
The enumeration date for this NPI number is 3/30/2017 and was last updated on 3/30/2017.