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NPI Code Detail

MEDICARE: SONYA JACKSON MEDICAL ASSISTANT

MEDICARE:   SONYA  JACKSON  MEDICAL ASSISTANT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
13747A0650XAttendant Care Provider

General Provider Information

NPI Number : 1265392229
Entity Type Code : Individual
Provider Name (Legal Business Name) : SONYA JACKSON MEDICAL ASSISTANT
Provider Business Mailing Address
First Line : 2780 BRAMBLEBUSH CT
Second Line :
City : COLUMBUS
State : OH
Zip : 43224-2505
Country : US
Telephone Number : 614-368-4162
Fax Number :
Provider Business Practice Location Address
First Line : 2780 BRAMBLEBUSH CT
Second Line :
City : COLUMBUS
State : OH
Zip : 43224-2505
Country : US
Telephone Number : 614-368-4162
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/13/2025
Last Update Date : 11/13/2025

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Directions to “ SONYA JACKSON MEDICAL ASSISTANT” Practice Location

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