# DR. JEFFREY A JACKSON

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

## Provider details

- **NPI number:** 1972563443
- **Gender:** Man
- **Credential:** MD

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207RE0101X | Endocrinology, Diabetes & Metabolism Physician | 4301045865 | MI | — |
| 207RE0101X | Endocrinology, Diabetes & Metabolism Physician | G8711 | TX | Yes |

## Other

- **Enumeration date:** 03/27/2006
- **Last updated:** 11/19/2021

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 1010571-01 | CSHCN | TX |
| 05 | — | 1010571-02 | — | TX |
| 05 | — | 201350760 | — | IN |
| 01 | — | 460002994 | RR/MEDICARE | TX |
| 01 | — | 807573 | BLUE SHIELD | TX |