National Provider Identifier Database

MARTHA A JACKSON, DPM – NPI #1053372946
Podiatrist

A podiatrist is a person qualified by a Doctor of Podiatric Medicine (D.P.M.) degree, licensed by the state, and practicing within the scope of that license. Podiatrists diagnose and treat foot diseases and deformities. They perform medical, surgical and other operative procedures, prescribe corrective devices and prescribe and administer drugs and physical therapy.


Contact Information

MARTHA A JACKSON, DPM
2501 CRESTWOOD RD
SUITE 101
NORTH LITTLE ROCK, AR72116-7615
Phone: 501-771-4785
Fax: 501-771-4787
Website:
Specialty Taxonomy Code
* Podiatrist 213E00000X

* Indicates primary specialty

NPI Profile & details for MARTHA A JACKSON

NPI Number 1053372946
Credentials DPM (Doctor of Podiatric Medicine)
Entity Individual
Enumeration date 03/30/2006
Last updated 07/14/2020 - About 6 years ago
Sole proprietor1 Yes
Identifiers
  • AR License #: 87
  • AR Medicaid: 110420717
  • Other: 5997156 AETNA
  • Other: 9468520001 CIGNA
  • Other: 0580220001 PALMETTO DME
  • Other: 2720028 UNITED HEALTH CARE
  • AR Other: 56243 AR BCBS
  • AR Other: 56243 FEP BCBS
  • AR Other: 56243 FIRST SOURCE
  • AR Other: 56243 HEALTH ADVANTAGE
  • AR Other: 16253000040 QUAL CHOICE
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.

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