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

Russell Emanuel Jackson, AT

Individual provider Athletic Trainer · NPI 1932622867

Russell Emanuel Jackson, AT is an Athletic Trainer in Goldsboro, North Carolina. Licensed in Ohio. Registered with an NPI since 2017.

Licensed in
OH
In the registry since
2017

Practice location Address checks out

406 Sheridan Forest Rd
Goldsboro, NC 27534-7103
Phone: (419) 215-8888
Show map & directions

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

Specialties & licences

Athletic Trainer (primary) Taxonomy 2255A2300X · Licence AT0005240 (OH)

Record details

NPI number1932622867
Entity typeIndividual (Type 1)
GenderMale
Credentials AT
Sole proprietorNo
NPI enumeratedJuly 23, 2017
Last updated in NPPESAugust 3, 2021
Certification dateAugust 3, 2021

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