LARRY A. JACKSON MD PC NPI 1134565849

NPI Information

  • NPI: 1134565849
  • Provider Name: LARRY A. JACKSON, MD PC
  • Classification: General Practice - 208D00000X
  • Entity Type: Organization
  • Address: 1717 CENTENNIAL BLVD
    SUITE 7
    SPRINGFIELD, OR
    ZIP 97477
  • Phone: (541) 726-0550

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NPI Details

LARRY A. JACKSON, MD PC is a general practice in Springfield, OR. The provider is a physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions. Source: National Uniform Claim Committee LARRY A. JACKSON, MD PC NPI is 1134565849. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

1717 CENTENNIAL BLVD
SUITE 7
SPRINGFIELD, OR
ZIP 97477-378
Phone: (541) 726-0550
Fax: (541) 726-7485

The provider's authorized official is Larry Arthur Jackson .
The authorized official title is President and has the following contact phone number (541) 726-0550.

The enumeration date for this NPI number is 5/21/2013 and was last updated on 5/21/2013.

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
1208D00000XGeneral Practice08513OREGONYes

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: 11/21/2025

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