Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Jackson ENT Clinic , PSC

Organization Oral & Maxillofacial Surgery (D.M.D.) · NPI 1831225465

Jackson ENT Clinic , PSC is an Oral & Maxillofacial Surgery (D.M.D.) in Jackson, Kentucky. Licensed in Kentucky. Registered with an NPI since 2007.

Licensed in
KY
In the registry since
2007
Specialties on file
2
What do these letters mean?
PSC — Professional service corporation
A form of business registration, not a clinical qualification.

See every abbreviation used in this directory →

Practice location Address checks out

1550 Highway 15 S Ste 29
Jackson, KY 41339-9221
Phone: (606) 666-9909
Fax: (606) 666-9982
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Otolaryngology Physician (primary) Taxonomy 207Y00000X · Licence 36227 (KY)
Oral & Maxillofacial Surgery (D.M.D.) Taxonomy 204E00000X · Licence 36227 (KY)

Record details

NPI number1831225465
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Tariq Sartawi — Owner · (606) 666-9909
NPI enumeratedFebruary 26, 2007
Last updated in NPPESNovember 14, 2008
Mailing addressPo Box 768, Jackson, KY 41339-0768