Kevin Gordon Jackson in Phoenix - Geriatric Medicine
Kevin Gordon Jackson - NPI 1225032782
Kevin Gordon Jackson is a Geriatric Medicine in Phoenix, Arizona. Kevin Gordon Jackson practices all healthcare services and medical treatments related to Geriatric Medicine. The NPI Number for Kevin Gordon Jackson is 1225032782. The last update date is 2023-04-13.
Kevin Gordon Jackson's current location address is 7600 N 16th St Ste 112, Phoenix, Arizona. You can contact this provider via phone number 6028300605. The mailing address for Kevin Gordon Jackson is 7600 N 16th St Ste 112, Phoenix, Arizona. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Kevin Gordon Jackson |
|---|---|
| Address | 7600 N 16th St Ste 112, Phoenix, Arizona |
| Phone Number | 6028300605 |
| Fax Number | |
| Sole Proprietor | N |
| Credentials | M.D. |
NPI Number Detail
| NPI Number | 1225032782 |
|---|---|
| Provider Enumeration Date | 2005-06-11 |
| Last Updated Date | 2023-04-13 |
Provider Mailing Address Detail
| Address | 7600 N 16th St Ste 112 |
|---|---|
| City | Phoenix |
| State | Arizona (AZ) |
| Post Code | 8502044460 |
| Phone Number | 6028300605 |
| Fax Number |
Provider's Primary Taxonomy Detail
| Speciality | Geriatric Medicine |
|---|---|
| Taxonomy | 207Qg0300X |
| Licence No | 22105 |
|
Definition: 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 |
|
Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 428525 | AZ | -- | |
| AZ0728320 | AZ | BLUE CROSS OF ARIZONA |
Post Comment/ Review Below
What is the unique 10-digit identifier code issued to Kevin Gordon Jackson by the Centers for Medicare & Medicaid Services?
The Kevin Gordon Jackson has been assigned the NPI (National Provider Identifier) 1225032782 by the CMS (Centers for Medicare & Medicaid Services). This 10-digit code serves as a unique identification number for healthcare providers.
Where is the Kevin Gordon Jackson located?
The Kevin Gordon Jackson is located at 7600 N 16Th St Ste 112, Phoenix, AZ 8502044460.
What is the Kevin Gordon Jackson's area of specialization and corresponding taxonomy classification?
The Kevin Gordon Jackson's specialty field is Geriatric Medicine, and it falls under the taxonomy code 207Qg0300X, which categorizes healthcare providers based on their specialties.
On what date did the Centers for Medicare & Medicaid Services originally issue the 1225032782 to Kevin Gordon Jackson?
The Centers for Medicare & Medicaid Services originally issued the 1225032782 to Kevin Gordon Jackson on 2005-06-11.
When was the information regarding Kevin Gordon Jackson most recently updated?
The details pertaining to the Kevin Gordon Jackson, including its address, specialty, and other relevant information, were last refreshed on 2023-04-13.
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