NPI 1346763786 · live from the CMS NPI Registry
Jackson B Austin, PA-C
Physician Assistant in Madison, WV. National Provider Identifier 1346763786, active.
NPI record
| NPI | 1346763786 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Physician Assistant 363A00000X |
| Practice location | 701 Madison Ave, Madison, WV 25130 |
| Practice phone | 304-369-1230 |
| Mailing address | 9336 S Mountain Rd, Pound, VA 24279 |
| Enumerated | July 18, 2017 |
| Last updated | July 18, 2017 |
| Sole proprietor | No |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Physician Assistant primary | 363A00000X | 2052 (WV) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.