Healthcare Provider Details
I. General information
NPI: 1710867940
Provider Name (Legal Business Name): JACKSON CURTIS MCKEEHAN DC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 09/08/2025
Last Update Date: 09/08/2025
Certification Date: 09/07/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
7615 AUSTIN BLUFFS PKWY UNIT 100
COLORADO SPRINGS CO
80920-2901
US
IV. Provider business mailing address
7615 AUSTIN BLUFFS PKWY UNIT 100
COLORADO SPRINGS CO
80920-2901
US
V. Phone/Fax
- Phone: 719-522-1219
- Fax:
- Phone: 719-522-1219
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 111NI0900X |
| Taxonomy | Internist Chiropractor |
| License Number | CHR.0008982 |
| License Number State | CO |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: