Individual
DAVID M. JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
9321 W THOMAS RD STE 205, PHOENIX, AZ 85037-3392
(866) 974-2673
Mailing address
18444 N 25TH AVE, STE 310, PHOENIX, AZ 85023-1261
(866) 974-2673
(866) 939-2673
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
49686
AZ
207X00000X
Orthopaedic Surgery Physician
49686
AZ
207XS0117X
Orthopaedic Surgery of the Spine Physician
Primary
49686
AZ
207XS0117X
Orthopaedic Surgery of the Spine Physician
A120606
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
958173
—
AZ
01
—
PENDING
MEDICARE AZ
AZ
Enumeration date
02/17/2007
Last updated
03/26/2025
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