DoctorDataHub
Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

MR. THOMAS MICHAEL JACKSON, DO

Active Sole Proprietor

MR. THOMAS MICHAEL JACKSON, DO is a Emergency Medicine healthcare provider located in CARMEN, Idaho. NPI 1134380694 is currently active in the NPPES registry. Verify at CMS.

Emergency Medicine · CARMEN, ID

Registration Details

NPI Number
1134380694
Provider Type
Individual
Gender
Male
NPI Issued
Jun 18, 2008 (18.139657818453 yrs)
Last Updated
Jun 18, 2008
License
021 (ID)
Sole Proprietor
Yes

Practice Information

Address
7 BITTERROOT ROAD
CARMEN, ID, 83462
Browse ID providers · Browse ZIP 83462
Phone
2087568047
Primary Specialty
Emergency Medicine
207P00000X
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.