| Doctor Name: | DR. JACKSON FRIEDMAN |
| NPI Number: | 1457419228 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | DO |
| License Number: | 237180 |
| Business Practice Address: | 100 Keokea Pl Kula, HI - 967907450 |
| Business Phone Number: | 8083541698 |
| Business Fax Number: | |
| Mailing Address: | Po Box 840, KULA |
| State: | HI |
| Postal Code: | 967900840 |
| Phone Number: | 8083541698 |
| Fax Number: | |
| NPI Enumeration Date: | 12/05/2006 |
| NPI Last Update Date: | 05/14/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 204C00000X |
| License Number: | 237180 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | NY |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | Neuromusculoskeletal Medicine, Sports Medicine |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |