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

Kenneth Jackson, PA-C

Individual provider Medical Physician Assistant · NPI 1033238936

Kenneth Jackson, PA-C is a Medical Physician Assistant in Berkley, Michigan. Licensed in Michigan. Registered with an NPI since 2007.

Licensed in
MI
In the registry since
2007
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

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Practice location Address checks out

27901 Woodward Ave Ste 300
Berkley, MI 48072-0919
Phone: (248) 837-2443
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Medical Physician Assistant (primary) Taxonomy 363AM0700X · Licence 5601001747 (MI)

Record details

NPI number1033238936
Entity typeIndividual (Type 1)
GenderMale
Credentials PA-C
Sole proprietorNo
NPI enumeratedMarch 29, 2007
Last updated in NPPESJanuary 25, 2021
Certification dateJanuary 25, 2021
Mailing address26901 Beaumont Blvd Ste 3d, Southfield, MI 48033-3849

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