Jefferd Jackson Daniel

Individual provider Active NPI Physician Assistant · Trenton, GA

NPI 1821950700 · NPPES record last updated Nov 28, 2025

Key facts

NPI
1821950700
Entity type
Individual (NPI type 1)
Primary specialty
Physician Assistant 363A00000X
Practice address
3253 New Home Rd
Trenton, GA 30752-5705
Phone
(909) 894-9980
NPI assigned
Nov 28, 2025
Sex
Male
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X Yes

Addresses

Primary practice location

3253 New Home Rd
Trenton, GA 30752-5705

Mailing address

3253 New Home Rd
Trenton, GA 30752-5705
Phone (909) 894-9980

Other providers in Trenton, GA

All providers in Trenton, GA · Physician Assistant in Georgia

Sources for this page

Verify at the official NPI Registry.