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

Mr. Timothy Lawrence Jackson, PA

Individual provider Medical Physician Assistant · NPI 1124338504

Mr. Timothy Lawrence Jackson, PA is a Medical Physician Assistant in Williams, Arizona. Practices as a sole proprietor and works from 2 locations. Licensed in Arizona.

Licensed in
AZ
In the registry since
2010
What do these letters mean?
PA — Physician Assistant
A licensed clinician who examines, diagnoses and treats under a physician's supervision.

See every abbreviation used in this directory →

Practice location Address checks out

300 S 6th St
Williams, AZ 86046-0110
Phone: (928) 635-4441
Show map & directions

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

Additional practice locations (1)

  • 2722 N Mariah Way, Flagstaff, AZ 86004-7550 — (928) 527-7759

Specialties & licences

Medical Physician Assistant (primary) Taxonomy 363AM0700X · Licence 5407 (AZ)

Record details

NPI number1124338504
Entity typeIndividual (Type 1)
GenderMale
Credentials PA
Sole proprietorYes
NPI enumeratedOctober 19, 2010
Last updated in NPPESJuly 21, 2021
Certification dateJuly 21, 2021

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