National Provider Identifier Database

KEVIN G JACKSON, MD – NPI #1225032782
Geriatric Medicine

A family medicine physician with special knowledge of the aging process and special skills in the diagnostic, therapeutic, preventive and rehabilitative aspects of illness in the elderly. This specialist cares for geriatric patients in the patient's home, the office, long-term care settings such as nursing homes, and the hospital.


Contact Information

KEVIN G JACKSON, MD
7600 N 16TH ST STE 112
PHOENIX, AZ85020-4446
Phone: 602-830-0605
Fax:
Website:
Specialty Taxonomy Code
* Geriatric Medicine 207QG0300X

* Indicates primary specialty

NPI Profile & details for KEVIN G JACKSON

NPI Number 1225032782
Credentials MD
Entity Individual
Enumeration date 06/11/2005
Last updated 04/13/2023 - About 3 years ago
Sole proprietor1 No
Identifiers
  • AZ License #: 22105
  • AZ Medicaid: 428525
  • AZ Other: AZ0728320 BLUE CROSS OF ARIZONA
Hospital affiliation n/a

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.

Reviews for KEVIN G JACKSON, MD

There are currently no reviews for KEVIN G JACKSON, MD


NPIdb - Home
v2.201