Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days.
Individual
HERSCHEL S JACKSON JR.
Active
Individual
HERSCHEL S JACKSON JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
15974
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000045254
ANTHEM ID
KY
01
—
020006711
RAILROAD MEDICARE ID
KY
05
—
64159742
—
KY
Enumeration date
03/02/2006
Last updated
12/21/2010
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Sign upProduct
Developers