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Search › Pennsylvania › 207R00000X

Cody Jackson, MD, PHD

NPI 1255033304 · on the registry since 2023

Practice

Address
3400 Civic Center Blvd Fl 1
Philadelphia, PA 19104
Phone
(215) 615-5864
Organisation at this address
University Of Pennsylvania
Faith & Hope Boutique, Llc
University Of Penn-Medical Group
University Of Penn-Medical Group
University Of Penn-Medical Group
Inferred from a shared address, not stated in the registry.
Clinicians at this address
1,049

Registry record

Primary taxonomy
207R00000X
207R00000X
Also registered as
207RC0200X
207RP1001X
Licence states on file
PA, OR
From the registry's licence fields, which are often incomplete.
Sex
Male
Record last updated
2026-07-08

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Pennsylvania