Individual
DR. RICHARD ALLEN JACKSON
Active
Individual
DR. RICHARD ALLEN JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
0101030877
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
006044140
—
VA
01
—
041765-00000
QUAL CHOICE
VA
01
—
0542922
ANTHEM/TRIGON/HMO/PPO/HEA
VA
01
—
110054158
MCR RAILROAD
VA
01
—
44130
SENTAR
VA
01
—
491268
AETNA/HMO/PPO
VA
01
—
541588928
UNITEDHEALTHCARE
VA
01
—
541588928/4971410007
CIGNA/HMO/PPO
VA
01
—
C03251
MCR GROUP#
VA
Enumeration date
10/18/2006
Last updated
03/19/2025
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