Search › Oklahoma › 207W00000X
Jared Jackson, M.D
NPI 1730476730 · on the registry since 2011 · sole proprietor
Practice
- Address
- 3431 S Boulevard Ste 105
Edmond, OK 73013 - Phone
- (405) 771-0880
- Fax
- (405) 562-2116
- Organisation at this address
- Boulevard Family Clinic Llc
Tina Joy Aprn-Cnp, Fnp-Bc, Llc
Eye Care Specialists Of Oklahoma PllcInferred from a shared address, not stated in the registry. - Clinicians at this address
- 4
Additional practice sites
- 2150 S Douglas Blvd Ste C, Midwest City, OK
Registry record
- Primary taxonomy
- 207W00000X
207W00000X
- Also registered as
- 261QM2500X
390200000X - Licence states on file
- OK, IN
From the registry's licence fields, which are often incomplete.
- Sex
- Male
- Record last updated
- 2020-04-21
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 Oklahoma