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

Mr. David Kenneth Jackson, ABOC

Individual provider Optician · NPI 1851566467

Mr. David Kenneth Jackson, ABOC is an Optician in Baltimore, Maryland. Practices as a sole proprietor. Licensed in Maryland.

Licensed in
MD
In the registry since
2008

Practice location Address checks out

4200 Elderon Ave
Baltimore, MD 21215-4802
Phone: (410) 664-4508
Fax: (410) 664-0605
Show map & directions

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

Specialties & licences

Optician (primary) Taxonomy 156FX1800X · Licence 072195 (MD)

Record details

NPI number1851566467
Entity typeIndividual (Type 1)
GenderMale
Credentials ABOC
Sole proprietorYes
NPI enumeratedApril 24, 2008
Last updated in NPPESApril 24, 2008
Mailing address4200 Elderon Ave, Baltimore, MD 21215-4802

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