Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
MATTHEW R JACKSON, D.O.
ActiveMATTHEW R JACKSON, D.O. is a Sports Medicine healthcare provider located in TRAVERSE CITY, Michigan. NPI 1588897896 is currently active in the NPPES registry. Verify at CMS.
Sports Medicine · TRAVERSE CITY, MI
Registration Details
- NPI Number
- 1588897896
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Sep 2, 2009 (16.920024975553 yrs)
- Last Updated
- Dec 21, 2020
- Licenses
-
5101018472 (MI)34.010954 (OH)5101018472 (MI)
Practice Information
- Address
-
1225 W FRONT STTRAVERSE CITY, MI, 496842368Browse MI providers · Browse ZIP 49684
- Phone
- 2319350788
- Fax
- 2319350787
- Primary Specialty
-
Sports Medicine
207QS0010X
- Additional Specialty
- Sports Medicine
- Additional Specialty
- Sports Medicine
Other Sports Medicine Providers in TRAVERSE CITY, MI
| Name | Credential | NPI |
|---|---|---|
| SARAH MAE BANCROFT-TREADWAY | M.D. | 1275743767 |
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.