Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
MARK A JACKSON, MD
Active Sole ProprietorMARK A JACKSON, MD is a Geriatric Medicine healthcare provider located in TRAVERSE CITY, Michigan. NPI 1073585238 is currently active in the NPPES registry. Verify at CMS.
Geriatric Medicine · TRAVERSE CITY, MI
Registration Details
- NPI Number
- 1073585238
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Feb 2, 2006 (20.554258476462 yrs)
- Last Updated
- Oct 23, 2015
- Licenses
-
051555 (MI)4301051555 (MI)
- Sole Proprietor
- Yes
Practice Information
- Address
-
1000 PAVILIONS CIRCLEMARK A JACKSON MD PLCTRAVERSE CITY, MI, 49684Browse MI providers · Browse ZIP 49684
- Phone
- 2319350913
- Fax
- 2319350984
- Primary Specialty
-
Geriatric Medicine
207QG0300X
- Additional Specialty
- Geriatric Medicine
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.