# DR. ADAM JACKSON

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** Yes

## Provider details

- **NPI number:** 1023558376
- **Gender:** Man
- **Credential:** BMSCD, MBSC, CNIM

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 173F00000X | Sleep Specialist (PhD) | — | NULL | Yes |
| 204R00000X | Electrodiagnostic Medicine Physician | 2045 | IL | — |
| 2084N0600X | Clinical Neurophysiology Physician | 2045 | TN | — |

## Other

- **Enumeration date:** 03/06/2017
- **Last updated:** 04/25/2020