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MRS. DOREEN ONIPEDE JACKSON MD NPI 1649615287


NPI Information

NPI: 1649615287
Provider Name: MRS. DOREEN ONIPEDE JACKSON, MD
Classification: Colon & Rectal Surgery - 208C00000X
Entity Type: Individual

PECOS Registration: Yes

Address:
101 BODIN CIRCLE
TRAVIS AIR FORCE BASE, CA
ZIP 94535
Phone: (919) 753-6879
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MRS. Doreen Onipede Jackson, MD is a colon rectal surgery in Travis Air Force Base, CA. The provider is a colon and rectal surgeon is trained to diagnose and treat various diseases of the intestinal tract, colon, rectum, anal canal and perianal area by medical and surgical means. This specialist also deals with other organs and tissues (such as the liver, urinary and female reproductive system) involved with primary intestinal disease. MRS. Doreen Onipede Jackson, MD NPI is 1649615287. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

101 BODIN CIRCLE
TRAVIS AIR FORCE BASE, CA
ZIP 94535-800
Phone: (919) 753-6879

The NPI 1649615287 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 5/9/2013 and was last updated on 8/19/2022.


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
1208600000XSurgery171636CALIFORNIANo
2208C00000XColon & Rectal SurgeryME139661FLORIDANo
3208D00000XGeneral Practice204413NORTH CAROLINANo
4208C00000XColon & Rectal Surgery171636CALIFORNIAYes

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.