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DOUGLAS T JACKSON MD NPI 1962472407


NPI Information

NPI: 1962472407
Provider Name: DOUGLAS T JACKSON, MD
Classification: Anesthesiology - 207LC0200X
Entity Type: Individual

Specialization: Critical Care Medicine

Address:
150 BARGEN ST
F 102
NEWARK, NJ
ZIP 07103
Phone: (973) 972-3555
Get Directions

Douglas T Jackson, MD is a critical care medicine anesthesiology in Newark, NJ. The provider is an anesthesiologist, who specializes in critical care medicine diagnoses, treats and supports patients with multiple organ dysfunction. This specialist may have administrative responsibilities for intensive care units and may also facilitate and coordinate patient care among the primary physician, the critical care staff and other specialists. Douglas T Jackson, MD NPI is 1962472407. 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:

150 BARGEN ST
F 102
NEWARK, NJ
ZIP 07103
Phone: (973) 972-3555
Fax: (973) 972-3510

The enumeration date for this NPI number is 1/26/2006 and was last updated on 7/8/2007.


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
1207LC0200XAnesthesiologyCritical Care Medicine25MA06601400NEW JERSEYYes

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 IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1003800MEDICARE ID-TYPE UNSPECIFIEDNEW JERSEY
26716407MEDICAIDNEW JERSEY
3B19826MEDICARE UPIN

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.