Dr KENNETH JACKSON is a male medical professional, specializing in Physician Assistant. He graduated in 1981.
WILLIAM BEAUMONT HOSPITAL
27901 WOODWARD AVE
BERKLEY
MI
480720921
Tel: 2485450070
| Npi | 1033238936 |
| Pac Id | 2668558826 |
| Professional Enrollment Id | I20080327000729 |
| Last Name | JACKSON |
| First Name | KENNETH |
| Middle Name | |
| Suffix | |
| Gender | M |
| Credential | |
| Medical School Name | OTHER |
| Graduation Year | 1981 |
| Primary Specialty | PHYSICIAN ASSISTANT |
| Secondary Specialty 1 | |
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| Organization Legal Name | WILLIAM BEAUMONT HOSPITAL |
| Group Practice Pac Id | 9335051093 |
| Number Of Group Practice Members | 707 |
| Line 1 Street Address | 27901 WOODWARD AVE |
| Line 2 Street Address | |
| Marker Of Address Line 2 Suppression | Y |
| City | BERKLEY |
| State | MI |
| Zip Code | 480720921 |
| Phone Number | 2485450070 |
| Hospital Affiliation Ccn 1 | 230130 |
| Hospital Affiliation Lbn 1 | BEAUMONT HOSPITAL, ROYAL OAK |
| Hospital Affiliation Ccn 2 | |
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| Professional Accepts Medicare Assignment | Y |
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