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

Jackson Thomas Gibson

Individual provider Student in an Organized Health Care Education/Training Program · NPI 1942127204

Jackson Thomas Gibson is a Student in an Organized Health Care Education/Training Program in Glendale, Arizona. Practices as a sole proprietor. Licensed in Arizona.

Licensed in
AZ
In the registry since
2026

Practice location Address checks out

19555 N 59th Ave
Glendale, AZ 85308-6813
Phone: (623) 572-3200
Show map & directions

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

Specialties & licences

Student in an Organized Health Care Education/Training Program (primary) Taxonomy 390200000X (AZ)

Record details

NPI number1942127204
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorYes
NPI enumeratedJune 29, 2026
Last updated in NPPESJune 29, 2026
Certification dateJune 30, 2026
Mailing address19555 N 59th Ave, Glendale, AZ 85308-6813

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