# JACKSON LIANG

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

## Provider details

- **NPI number:** 1740575539
- **Gender:** Man
- **Credential:** D.O.

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207R00000X | Internal Medicine Physician | 5101025144 | MI | — |
| 207R00000X | Internal Medicine Physician | 55359 | MN | — |
| 207RC0000X | Cardiovascular Disease Physician | 5101025144 | MI | — |
| 207RC0000X | Cardiovascular Disease Physician | 5101025144 | MN | — |
| 207RC0001X | Clinical Cardiac Electrophysiology Physician | 5101025144 | MI | Yes |

## Other

- **Enumeration date:** 06/09/2011
- **Last updated:** 09/28/2026

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | ENROLLED | — | MN |