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Contact Information

LYLE T JACKSON JR, MD
55 COBURG RD
EUGENE, OR97401-2433
 Phone: 541-485-8111
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Foot and Ankle Surgery

207XX0004X 02 Physician/General Surgery
 

Orthopaedic Surgery

207X00000X 02 Physician/General Surgery
Indicates primary specialty

NPI Profile & details for LYLE T JACKSON JR · (Male)

NPI Number 1144540790
Status Active
Credentials MD
Entity Individual
Enumeration date 06/06/2010
Last updated 12/27/2022 - About 3 years ago
Sole proprietor 1 No
Identifiers
  • NV License # 16057
  • OR License # MD176209
  • SC License # 32738
Hospital affiliation(s)
  • MCKENZIE-WILLAMETTE MEDICAL CENTER - (Acute Care)
    1460 G STREET
    SPRINGFIELD, OR 97477
  • SACRED HEART MEDICAL CENTER - RIVERBEND - (Acute Care)
    3333 RIVERBEND DRIVE
    SPRINGFIELD, OR 97477
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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