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

Russell Patrick Jackson

Individual provider Student in an Organized Health Care Education/Training Program · NPI 1699322578

Russell Patrick Jackson is a Physician Assistant in Casa Grande, Arizona. Qualified in 2021, 5 years ago. Practices with Clinica La Familia PC, a 38-clinician group and accepts Medicare assignment. Licensed in Arizona.

Years since qualifying
5
Licensed in
AZ
In the registry since
2019
Specialties on file
2
Claim this listing Report a problem Suggest an edit

Practice location Address checks out

301 E Cottonwood Ln Ste 1&2
Casa Grande, AZ 85122-2551
Phone: (602) 569-3999
Fax: (520) 340-4359
Show map & directions

Directions in Google Maps · Apple Maps · OpenStreetMap

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

Specialties & licences

Medical Physician Assistant (primary) Taxonomy 363AM0700X · Licence 8654 (AZ)
Student in an Organized Health Care Education/Training Program Taxonomy 390200000X

Record details

NPI number1699322578
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorYes
NPI enumeratedAugust 24, 2019
Last updated in NPPESSeptember 6, 2024
Certification dateSeptember 6, 2024
Mailing address1753 E Cortez Dr, Casa Grande, AZ 85122-6319

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2021 (5 years in practice)
Group practice Clinica La Familia Pc — 38 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Other providers in Casa Grande