Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
DR. EDWARD WILLIAM JACKSON, MD
Active Sole ProprietorDR. EDWARD WILLIAM JACKSON, MD is a Adolescent Medicine healthcare provider located in SPRINGVILLE, Utah. NPI 1487367728 is currently active in the NPPES registry. Verify at CMS.
Adolescent Medicine · SPRINGVILLE, UT
Registration Details
- NPI Number
- 1487367728
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Jan 2, 2023 (3.6098336879768 yrs)
- Last Updated
- Jan 2, 2023
- Licenses
-
183721-1205 (UT)183721-1205 (UT)
- Sole Proprietor
- Yes
Practice Information
- Address
-
786 S LEFT HAND FORK HOBBLE CREEK CYNSPRINGVILLE, UT, 846635916Browse UT providers · Browse ZIP 84663
- Phone
- 8014899381
- Primary Specialty
-
Adolescent Medicine
207QA0505X
- Additional Specialty
- Family 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.