Taylor Kiyota Jackson, OD

Optometrist · Frederick, CO

Individual Active NPI

NPI number 1275158404

Practice location

5900 Keyes St Ste 101
Frederick, CO 80504-5956
Phone
(303) 833-1056

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NPI record

NPI
1275158404
Entity type
Individual (Type 1)
Enumeration date
June 13, 2020
Last updated
May 15, 2021
Certified
May 15, 2021
Sole proprietor
No

Specialties & taxonomy codes

TaxonomyCodeLicenseState
Optometrist Primary 152W00000X OPT0003599 CO

Mailing address

6408 DRY Fork Dr
Frederick, CO 80516-9510
Phone
(303) 921-2307

Other practice locations (1)

  • 1600 Iron Horse Dr Apt B102, Longmont, CO 80501-5704 · (303) 921-2307

About Dr. Jackson

Taylor Kiyota Jackson, OD is a healthcare provider registered in the NPI registry with the primary taxonomy Optometrist (code 152W00000X). The practice location is 5900 Keyes St Ste 101, Frederick, CO 80504-5956. The NPI number 1275158404 was assigned on June 13, 2020 and the record was last updated on May 15, 2021.

Dr. Jackson lists a license in the registry: #OPT0003599 (CO) 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 Taylor Kiyota Jackson, OD?

The NPI number is 1275158404.

What is the phone number of Dr. Jackson?

The phone number listed for the practice location is (303) 833-1056.

Where is Dr. Jackson located?

5900 Keyes St Ste 101, Frederick, CO 80504-5956.

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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