Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
DR. MARK D JACKSON, OD
Deactivated Sole ProprietorDR. MARK D JACKSON, OD is a Optometrist healthcare provider located in FORT COLLINS, Colorado. NPI 1023015005 is deactivated in the NPPES registry. Verify at CMS.
Optometrist · FORT COLLINS, CO
This NPI has been deactivated.
The record was deactivated on March 20, 2006.
Deactivated NPIs are no longer valid for billing or credentialing. The provider may have retired, changed practice status, or had their NPI administratively deactivated.
Verify current licensure status with the NPPES NPI Registry or the relevant state medical board before relying on this record.
Registration Details
- NPI Number
- 1023015005
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Jul 5, 2005 (0.70684931506849 yrs)
- Last Updated
- May 15, 2023
- Deactivated
- Mar 20, 2006
- License
-
2187 (CO)
- Sole Proprietor
- Yes
Practice Information
- Address
-
1250 E MAGNOLIA STFORT COLLINS, CO, 805242702Browse CO providers · Browse ZIP 80524
- Phone
- 9702240606
- Fax
- 9704939309
- Primary Specialty
-
Optometrist
152W00000X
Other Optometrist Providers in FORT COLLINS, CO
| Name | Credential | NPI |
|---|---|---|
| DR. MATTHEW J SKRDLA | O.D. | 1750377172 |
| DR. AMY S ABEL | O.D. | 1295724516 |
| DR. KYLE DAVID TREICK | OD | 1235129115 |
| EDITH G BOWMAN | OD | 1801886502 |
| DR. ERIC R REISLER | O.D. | 1356331839 |
| DR. SCOTT HAUGEN | O.D. | 1730160722 |
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.