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Contact Information

WESLEY P JACKSON, MD
2500 E PROSPECT RD
FORT COLLINS, CO80525-9718
 Phone: 970-493-0112
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Foot and Ankle Surgery

207XX0004X 02 Physician/General Surgery
Indicates primary specialty

NPI Profile & details for WESLEY P JACKSON · (Male)

NPI # 1194782995
Status Active
Credentials MD
Entity Individual
Enumeration date 04/27/2006
Last updated 12/16/2019 - About 6 years ago
Sole proprietor 1 No
Identifiers
  • CO License # DR.0044443
  • CO Medicaid 28656245
  • WY Medicaid 122675400
  • CO Other P00377217 RR MEDICARE
Hospital affiliation(s)
  • MEDICAL CENTER OF THE ROCKIES - (Acute Care)
    2500 ROCKY MOUNTAIN AVENUE
    LOVELAND, CO 80538
  • POUDRE VALLEY HOSPITAL - (Acute Care)
    1024 S LEMAY AVE
    FORT COLLINS, CO 80524
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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