CHAD EDWIN JACKSON MS ATC NPI 1518484245

NPI Information

NPI: 1518484245
Provider Name: CHAD EDWIN JACKSON, MS, ATC
Classification: Preventive Medicine - 2083S0010X
Entity Type: Individual

Specialization: Sports Medicine

Address:
14110 SIX MILE CYPRESS PKWY
FORT MYERS, FL
ZIP 33912
Phone: (239) 479-6411
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Chad Edwin Jackson, MS, ATC is a sports medicine preventive medicine in Fort Myers, FL. The provider is a preventive medicine physician who specializes in the diagnosis and treatment of sports related conditions and injuries. Chad Edwin Jackson, MS, ATC NPI is 1518484245. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

14110 SIX MILE CYPRESS PKWY
FORT MYERS, FL
ZIP 33912-314
Phone: (239) 479-6411
Fax: (239) 768-2032

The enumeration date for this NPI number is 8/24/2017 and was last updated on 8/24/2017.

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 Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	2083S0010X	Preventive Medicine	Sports Medicine	AL2986	FLORIDA	Yes

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

NPI Synchronization or Removal

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