Individual
JEFFREY ALLEN JACKSON
Active
Individual
JEFFREY ALLEN JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
F5585
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
128033105
—
TX
01
—
1821090697
BLUE CROSS BLUE SHIELD
TX
01
—
P00866614
MEDICARE RAILROAD
TX
01
—
P01031010
RR MEDICARE
TX
Enumeration date
08/11/2005
Last updated
04/04/2022
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