Organization
JACKSON EYECARE, PC
Active
Other names
JACKSON EYE CARE
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARK D JACKSON OD (PRESIDENT)
(970) 224-0606
Entity
Organization
Contact information
Practice address
1250 E MAGNOLIA ST, FORT COLLINS, CO 80524-2702
(970) 224-0606
(970) 493-9309
Mailing address
1250 E MAGNOLIA ST, FORT COLLINS, CO 80524-2702
(970) 224-0606
(970) 493-9309
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
2187
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
90701283
—
CO
Enumeration date
03/13/2007
Last updated
10/22/2012
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