Individual
KURT T JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
22 OLD SHORT HILLS RD STE 202, LIVINGSTON, NJ 07039-5605
(201) 961-3975
Mailing address
22 OLD SHORT HILLS RD STE 202104, LIVINGSTON, NJ 07039-5604
(201) 961-3975
(973) 707-7349
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
25MA09011700
NJ
207WX0107X
Retina Specialist (Ophthalmology) Physician
Primary
25MA09011700
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
371351
—
NJ
Enumeration date
08/30/2007
Last updated
01/27/2025
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