Robert Leon Jackson, PH.D.

Clinical Psychologist · Springfield, IL

Individual Active NPI

NPI number 1104032952

Practice location

1201 S Veterans Pkwy
Suite B
Springfield, IL 62704-6321
Phone
(217) 793-2770

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NPI record

NPI
1104032952
Entity type
Individual (Type 1)
Enumeration date
May 15, 2007
Last updated
July 8, 2007
Sole proprietor
Yes

Specialties & taxonomy codes

TaxonomyCodeLicenseState
Clinical Psychologist Primary 103TC0700X — IL

Mailing address

16 Longbow Ln
Springfield, IL 62704-5324
Phone
(217) 787-3143

About Dr. Jackson

Robert Leon Jackson, PH.D. is a healthcare provider registered in the NPI registry with the primary taxonomy Clinical Psychologist (code 103TC0700X). The practice location is 1201 S Veterans Pkwy, Suite B, Springfield, IL 62704-6321. The NPI number 1104032952 was assigned on May 15, 2007 and the record was last updated on July 8, 2007.

Frequently asked questions

What is the NPI number of Robert Leon Jackson, PH.D.?

The NPI number is 1104032952.

What is the phone number of Dr. Jackson?

The phone number listed for the practice location is (217) 793-2770.

Where is Dr. Jackson located?

1201 S Veterans Pkwy, Suite B, Springfield, IL 62704-6321.

What is the taxonomy code for Dr. Jackson?

The primary taxonomy code is 103TC0700X – Clinical Psychologist.

Is this information correct?

All details come from the public NPPES registry. Providers can update their record at nppes.cms.hhs.gov; changes appear here after the next weekly update.

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