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KYLE WILLIAM JACKSON MD NPI 1194967604


NPI Information

NPI: 1194967604
Provider Name: KYLE WILLIAM JACKSON, MD
Classification: Pediatrics - 2080P0207X
Entity Type: Individual

Specialization: Pediatric Hematology-Oncology

PECOS Registration: Yes

Address:
705 RILEY HOSPITAL DR
ROC 4340
INDIANAPOLIS, IN
ZIP 46202
Phone: (317) 944-2143
Get Directions

Kyle William Jackson, MD is a pediatric hematology-oncology pediatrics in Indianapolis, IN with 15 years of experience. The provider is a pediatrician trained in the combination of pediatrics, hematology and oncology to recognize and manage pediatric blood disorders and cancerous diseases. Kyle William Jackson, MD NPI is 1194967604. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

Education
Medical School: WAYNE STATE UNIVERSITY SCHOOL OF MEDICINE
Graduation Year:2009

The provider's business location address is:

705 RILEY HOSPITAL DR
ROC 4340
INDIANAPOLIS, IN
ZIP 46202-109
Phone: (317) 944-2143
Fax: (317) 944-3107

The NPI 1194967604 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 3/30/2009 and was last updated on 1/18/2023.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
12080P0207XPediatricsPediatric Hematology-Oncology01078900INDIANAYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.