# MR. SIDNEY M JACKLER

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1316258262
- **Gender:** Man
- **Credential:** MPA, PA-C

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363A00000X | Physician Assistant | 0110003328 | VA | Yes |
| 363A00000X | Physician Assistant | PA.200780 | LA | Yes |

## Other

- **Enumeration date:** 06/25/2010
- **Last updated:** 05/07/2026

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 05555765 | — | MS |
| 05 | — | 2380362 | — | LA |