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DR. EDGAR BASIL JACKSON MD NPI 1598833410


NPI Information

NPI: 1598833410
Provider Name: DR. EDGAR BASIL JACKSON, MD
Classification: Psychiatry & Neurology - 2084P0800X
Entity Type: Individual

Specialization: Psychiatry

PECOS Registration: Yes

Address:
1225 W MITCHELL ST
223
MILWAUKEE, WI
ZIP 53204
Phone: (414) 383-4455
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DR. Edgar Basil Jackson, MD is a psychiatry psychiatry neurology in Milwaukee, WI with 67 years of experience. The provider is a Psychiatrist specializes in the prevention, diagnosis, and treatment of mental disorders, emotional disorders, psychotic disorders, mood disorders, anxiety disorders, substance-related disorders, sexual and gender identity disorders and adjustment disorders. Biologic, psychological, and social components of illnesses are explored and understood in treatment of the whole person. Tools used may include diagnostic laboratory tests, prescribed medications, evaluation and treatment of psychological and interpersonal problems with individuals and families, and intervention for coping with stress, crises, and other problems. DR. Edgar Basil Jackson, MD NPI is 1598833410. 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:

1225 W MITCHELL ST
223
MILWAUKEE, WI
ZIP 53204-383
Phone: (414) 383-4455
Fax: (414) 727-8730

The NPI 1598833410 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 11/30/2006 and was last updated on 11/22/2023.


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
12084A0401XPsychiatry & NeurologyAddiction MedicineAJ8930984 XJ8930984WISCONSINNo
22084P0800XPsychiatry & NeurologyPsychiatry13939WISCONSINYes

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
11598833410OTHERWISCONSINNPI
230954700MEDICAIDWISCONSIN

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.