Individual
DR. ROBERT FRANKLIN JACKSON II
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
1721 MAGNAVOX WAY, FORT WAYNE, IN 46804-1537
(260) 748-3650
(260) 748-3651
Mailing address
PO BOX 670, HUNTERTOWN, IN 46748-0670
(260) 748-3650
(260) 748-3651
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
02001273
IN
207X00000X
Orthopaedic Surgery Physician
Primary
02001273A
IN
207X00000X
Orthopaedic Surgery Physician
21371
WI
207X00000X
Orthopaedic Surgery Physician
76572
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000082970
ANTHEM BCBS
IN
01
—
02001273
LICENSE
IN
01
—
0426440001
DME
IN
05
—
100352280
—
IN
Enumeration date
05/11/2006
Last updated
01/30/2026
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