RICHARD J JACKSON MD NPI 1215027883

NPI Information

  • NPI: 1215027883
  • Provider Name: RICHARD J JACKSON, MD
  • Classification: Surgery - 2086S0120X
  • Specialization: Pediatric Surgery
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 1901 SW H K DODGEN LOOP
    TEMPLE, TX
    ZIP 76502
  • Phone: (254) 935-4000

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NPI Details

Richard J Jackson, MD is a pediatric surgery surgery in Temple, TX. The provider is a surgeon with expertise in the management of surgical conditions in premature and newborn infants, children and adolescents. Richard J Jackson, MD NPI is 1215027883. 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:

1901 SW H K DODGEN LOOP
TEMPLE, TX
ZIP 76502-500
Phone: (254) 935-4000
Fax: (254) 935-4111

The NPI 1215027883 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 10/13/2006 and was last updated on 6/8/2021.

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
12086S0120XSurgeryPediatric SurgeryN3094TEXASYes
22086S0120XSurgeryPediatric SurgeryN-8271ARKANSASNo

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
1125912907MEDICAIDTEXAS
2121627001MEDICAIDARKANSAS
3140442852MEDICAIDTEXAS
4125912908MEDICAIDTEXAS
5137345810MEDICAIDTEXAS

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: 3/30/2025

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