Michael Jackson, OD

Optometrist · Mankato, MN

Individual Active NPI

NPI number 1215091723

Practice location

1850 Adams St Ste 112
Mankato, MN 56001-4846
Phone
(507) 387-6358
Fax
(507) 387-4166

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NPI record

NPI
1215091723
Entity type
Individual (Type 1)
Enumeration date
December 20, 2006
Last updated
July 9, 2007
Sole proprietor
No

Specialties & taxonomy codes

TaxonomyCodeLicenseState
Optometrist Primary 152W00000X 2460 MN

Mailing address

11103 West Ave
Suite 6
San Antonio, TX 78213-1370
Phone
(210) 524-6663
Fax
(210) 524-6587

About Dr. Jackson

Michael Jackson, OD is a healthcare provider registered in the NPI registry with the primary taxonomy Optometrist (code 152W00000X). The practice location is 1850 Adams St Ste 112, Mankato, MN 56001-4846. The NPI number 1215091723 was assigned on December 20, 2006 and the record was last updated on July 9, 2007.

Dr. Jackson lists a license in the registry: #2460 (MN) for Optometrist. License numbers are self-reported to NPPES; verify them with the state licensing board.

Frequently asked questions

What is the NPI number of Michael Jackson, OD?

The NPI number is 1215091723.

What is the phone number of Dr. Jackson?

The phone number listed for the practice location is (507) 387-6358.

Where is Dr. Jackson located?

1850 Adams St Ste 112, Mankato, MN 56001-4846.

What is the taxonomy code for Dr. Jackson?

The primary taxonomy code is 152W00000X – Optometrist.

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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