| Doctor Name: | DR. ROBERT ANDREW JACKSON |
| NPI Number: | 1003895608 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | DPM |
| License Number: | SC2741L |
| Business Practice Address: | 440 Pellis Rd Greensburg, PA - 156014529 |
| Business Phone Number: | 7248539896 |
| Business Fax Number: | 7248539897 |
| Mailing Address: | 440 Pellis Rd, GREENSBURG |
| State: | PA |
| Postal Code: | 156014529 |
| Phone Number: | 7248539896 |
| Fax Number: | 7248539897 |
| NPI Enumeration Date: | 01/11/2006 |
| NPI Last Update Date: | 07/20/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 213ES0131X |
| License Number: | SC2741L |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | PA |
| Taxonomy Type: | Podiatric Medicine & Surgery Service Providers |
| Taxonomy Classification: | Podiatrist |
| Taxonomy Specialization: | Foot Surgery |
| Taxonomy Definition: | |