MARK A. JACKSON MD – NPI #1073585238
Family Medicine

A family medicine physician with special knowledge of the aging process and special skills in the diagnostic, therapeutic, preventive and rehabilitative aspects of illness in the elderly. This specialist cares for geriatric patients in the patient's home, the office, long-term care settings such as nursing homes, and the hospital.

MARK JACKSON is a physician located in TRAVERSE CITY, MI. NPPES has assigned the NPI number 1073585238 to MARK JACKSON on February 02, 2006. It is a Type-1 NPI, indicating this NPI number is associated with an individual. With multiple taxonomy codes selected, the primary taxonomy selected by this provider is 207QG0300X from the Health Care Provider Taxonomy code set, which is classified as Family Medicine, specializing in Geriatric Medicine

The NPI profile was previously updated about 11 years ago on Oct 23, 2015. Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for MARK JACKSON below.

NPI Profile for
MARK A. JACKSON

NPI Number
1073585238
Enumeration Date

(more than 20 years ago)
Entity Type
Type-1  Individual (Male)
Legal Name
MARK A. JACKSON
Credentials
MD
Primary location
1000 PAVILIONS CIRCLE
MARK A JACKSON MD PLC
TRAVERSE CITY, MI 49684
Phone: (231) 935-0913 Fax: (231) 935-0984
Mailing address
10850 E TRAVERSE HWY
STE 4400
TRAVERSE CITY, MI 49684-1364
Phone: (231) 346-6930 Fax: (231) 346-6017
Sole Proprietor
Yes
Updated
Identifiers

Identifiers for MARK JACKSON

Identifiers are used to associate other provider identifiers such as Medicaid or other insurers (ie:, Blue Cross, Blue Shield, Aetna, Kaiser-Permanente, etc.), with their NPI number. These identifiers can be used in matching an NPI number to an insurer's records. However, not all providers have such numbers and not all providers choose to include them in their NPI information.

DescriptionIssuerStateIdentifier
OTHERBLUE SHIELDMA080B86010
MEDICAIDMI1820487
Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
207QG0300X
- Family Medicine / Geriatric Medicine (Primary)
MI 4301051555
207Q00000X
- Family Medicine
MI 051555

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.