Individual
JOSEPH G JACKO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4885 OLENTANGY RIVER RD, SUITE 2-50, COLUMBUS, OH 43214-1952
(614) 451-1551
(614) 451-2326
Mailing address
4885 OLENTANGY RIVER RD, SUITE 2-50, COLUMBUS, OH 43214-1952
(614) 451-1551
(614) 451-2326
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
35.055488
OH
207RS0010X
Sports Medicine (Internal Medicine) Physician
35.055488
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0070272
—
OH
Enumeration date
06/23/2005
Last updated
07/30/2013
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