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Search › Georgia › 261QA0600X

Richard Jackson

NPI 1144192568 · on the registry since 2025 · sole proprietor

Practice

Address
811 Creste Dr
Decatur, GA 30035
Phone
(678) 881-7888
Organisation at this address
Juniors Society Inc
Juniors Society Inc
Inferred from a shared address, not stated in the registry.

Registry record

Primary taxonomy
261QA0600X
261QA0600X
Licence states on file
GA
From the registry's licence fields, which are often incomplete.
Sex
Male
Record last updated
2025-10-24

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Georgia