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

Individual provider Physician Assistant · NPI 1154891174

Jackson Deen, PA is a Physician Assistant in Gloucester, Virginia. Practices as a sole proprietor. Registered with an NPI since 2018.

In the registry since
2018
What do these letters mean?
PA — Physician Assistant
A licensed clinician who examines, diagnoses and treats under a physician's supervision.

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Practice location Address checks out

7519 Hospital Dr
Gloucester, VA 23061-4178
Phone: (804) 693-8899
Fax: (804) 693-8810
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X

Record details

NPI number1154891174
Entity typeIndividual (Type 1)
GenderMale
Credentials PA
Sole proprietorYes
NPI enumeratedDecember 3, 2018
Last updated in NPPESDecember 3, 2018
Mailing address856 J Clyde Morris Blvd Ste A, Newport News, VA 23601-1318

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