Individual
LYLE THOMAS JACKSON JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
55 COBURG RD, EUGENE, OR 97401-2433
(541) 485-8111
Mailing address
55 COBURG RD, EUGENE, OR 97401-2433
(541) 485-8111
(541) 342-6379
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
16057
NV
207X00000X
Orthopaedic Surgery Physician
32738
SC
207XX0004X
Orthopaedic Foot and Ankle Surgery Physician
16057
NV
207XX0004X
Orthopaedic Foot and Ankle Surgery Physician
Primary
MD176209
OR
Other
Enumeration date
06/06/2010
Last updated
12/27/2022
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