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Contact Information

TYSON A JACKSON, MD
1100 CENTRAL AVE SE
ALBUQUERQUE, NM87106-4930
 Phone: 505-841-1125
 Fax: 505-272-0475
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Emergency Medicine

207P00000X 93 Physician/Emergency Medicine
 

Student in an Organized Health Care Education/Training Program

390200000X
Indicates primary specialty

NPI Profile & details for TYSON A JACKSON · (Male)

NPI Number 1346701448
Status Active
Credentials MD
Entity Individual
Enumeration date 03/29/2019
Last updated 05/20/2026 - About 3 weeks ago
Sole proprietor 1 No
Identifiers
  • NM License # MD2023-0400
  • UT License # 13173246-1205
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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