Richard T Jackson, D.P.M.

NPI #1407859424 in Fort Wayne, Indiana

Provider Information

NPI Number: 1407859424
Entity Type: Individual
Name: Richard T Jackson, D.P.M.
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Podiatrist
Credential: D.P.M.
Enumeration Date: May 23, 2005
Last Updated: Nov 7, 2016

Practice Location

Address: 7601 W JEFFERSON BLVD
City: Fort Wayne
State: Indiana
ZIP Code: 46804-4133
Phone: (260) 436-8686

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Podiatrist	213E00000X	Primary

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Organizations

Provider Name	Specialty	City
Lincoln Pedic Clinic, Inc.	Podiatrist	Fort Wayne	AI Deep Dive

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