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

Wayne Jeffery Jackson, PA

Individual provider Medical Physician Assistant · NPI 1750387023

Wayne Jeffery Jackson, PA is a Medical Physician Assistant in Potsdam, New York. Works from 2 locations. Licensed in New York.

Licensed in
NY
In the registry since
2005
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

50 Leroy St
Potsdam, NY 13676-1786
Phone: (315) 265-3300
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 4 Fuller Street, Alexandria Bay, NY 13607 — (315) 482-2511

Specialties & licences

Medical Physician Assistant (primary) Taxonomy 363AM0700X · Licence 004496 (NY)

Record details

NPI number1750387023
Entity typeIndividual (Type 1)
GenderMale
Credentials PA
Sole proprietorNo
NPI enumeratedJune 22, 2005
Last updated in NPPESMarch 31, 2021
Certification dateMarch 31, 2021
Mailing address50 Leroy St, Potsdam, NY 13676-1786

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