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LYLE THOMAS JACKSON M.D. NPI 1144540790


NPI Information

NPI: 1144540790
Provider Name: LYLE THOMAS JACKSON, M.D.
Classification: Orthopaedic Surgery - 207XX0004X
Entity Type: Individual

Specialization: Foot and Ankle Surgery

Organization: COR CARE OF OR, LLC

PECOS Registration: Yes

Address:
55 COBURG RD
EUGENE, OR
ZIP 97401
Phone: (541) 485-8111
Get Directions

Lyle Thomas Jackson, M.D. is a foot and ankle surgery orthopaedic surgery in Eugene, OR with 14 years of experience. The provider is recognized by several state medical boards as a fellowship subspecialty program of orthopaedic surgery, foot and ankle surgeons deal with adult reconstructive foot and ankle surgery, adult foot and ankle trauma, sports medicine foot and ankle, and children's foot and ankle reconstructive surgery. Lyle Thomas Jackson, M.D. NPI is 1144540790. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

Education
Medical School: UNIVERSITY OF WASHINGTON SCHOOL OF MEDICINE
Graduation Year:2010

The provider's business location address is:

55 COBURG RD
EUGENE, OR
ZIP 97401-433
Phone: (541) 485-8111

The NPI 1144540790 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 6/6/2010 and was last updated on 7/28/2020.


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
1207X00000XOrthopaedic Surgery32738SOUTH CAROLINANo
2207X00000XOrthopaedic Surgery16057NEVADANo
3207XX0004XOrthopaedic SurgeryFoot and Ankle Surgery16057NEVADANo
4207XX0004XOrthopaedic SurgeryFoot and Ankle SurgeryMD176209OREGONYes

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: 11/14/2023

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.