Provider Type Icon

DR. RODGER DALE JACKSON DO MPH NPI 1588795546


NPI Information

NPI: 1588795546
Provider Name: DR. RODGER DALE JACKSON, DO, MPH
Classification: Emergency Medicine - 207P00000X
Entity Type: Individual

PECOS Registration: Yes

Address:
6777 W MAPLE RD
DEPARTMENT OF EMERGENCY MEDICINE
WEST BLOOMFIELD, MI
ZIP 48322
Phone: (313) 614-2186
Get Directions

DR. Rodger Dale Jackson, DO, MPH is an emergency medicine in West Bloomfield, MI. The provider is an emergency physician focuses on the immediate decision making and action necessary to prevent death or any further disability both in the pre-hospital setting by directing emergency medical technicians and in the emergency department. The emergency physician provides immediate recognition, evaluation, care, stabilization and disposition of a generally diversified population of adult and pediatric patients in response to acute illness and injury. DR. Rodger Dale Jackson, DO, MPH NPI is 1588795546. 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:

6777 W MAPLE RD
DEPARTMENT OF EMERGENCY MEDICINE
WEST BLOOMFIELD, MI
ZIP 48322-013
Phone: (313) 614-2186

The NPI 1588795546 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 3/8/2007 and was last updated on 1/22/2013.


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
1207R00000XInternal Medicine5101016798MICHIGANNo
2207P00000XEmergency Medicine5101016798MICHIGANYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
15315026355OTHERMICHIGANCONTROLLED SUBSTANCE LIC
25101016798OTHERMICHIGANLICENSE

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: 5/5/2024

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.