Individual
MR. ROBERT P JACKMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2821 DAGGETT AVE STE 200, KLAMATH FALLS, OR 97601-1106
(541) 274-8400
(541) 274-8405
Mailing address
2865 DAGGETT AVE, KLAMATH FALLS, OR 97601-1106
(541) 274-8400
(541) 274-8405
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD22734
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
059575000
BCBS OF OREGON
OR
01
—
140008075
RAILROAD
OR
05
—
286522
—
OR
01
—
H073533
PACIFIC SOURCE
OR
01
—
H64487
CHAMPUS
OR
01
—
XPY200005
CALIFORNIA WELFARE
CA
Enumeration date
06/06/2006
Last updated
02/11/2020
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