Jared Jackson, M.D.

NPI #1730476730 in Edmond, Oklahoma

Provider Information

NPI Number: 1730476730
Entity Type: Individual
Name: Jared Jackson, M.D.
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Ophthalmology
Credential: M.D.
Enumeration Date: Jun 29, 2011
Last Updated: Apr 21, 2020

Practice Location

Address: 3431 S BOULEVARD STE 105
City: Edmond
State: Oklahoma
ZIP Code: 73013-5514
Phone: (405) 771-0880

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Ophthalmology	207W00000X	Primary
Clinic/Center - Medical Specialty — Medical Specialty	261QM2500X
Student in an Organized Health Care Education/Training Program	390200000X

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