Individual
DR. CHAD HARMAN JACKSON
Active
Individual
DR. CHAD HARMAN JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
67198
WI
207W00000X
Ophthalmology Physician
Primary
M-15230
ID
207WX0200X
Ophthalmic Plastic and Reconstructive Surgery Physician
18691
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1184067498
—
WI
Enumeration date
04/17/2013
Last updated
07/21/2022
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