CHAD E. JACKSON MS, ATC – NPI #1518484245
Preventive Medicine

A preventive medicine physician who specializes in the diagnosis and treatment of sports related conditions and injuries.

CHAD JACKSON is a physician located in FORT MYERS, FL. NPPES has assigned the NPI number 1518484245 to CHAD JACKSON on August 24, 2017. It is a Type-1 NPI, indicating this NPI number is associated with an individual. The primary taxonomy selected by this provider is 2083S0010X from the Health Care Provider Taxonomy code set, which is classified as Preventive Medicine, specializing in Sports Medicine

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 CHAD JACKSON below.

NPI Profile for
CHAD E. JACKSON

NPI Number
1518484245
Enumeration Date

(about 9 years ago)
Entity Type
Type-1  Individual (Male)
Legal Name
CHAD E. JACKSON
Credentials
MS, ATC
Primary location
14110 SIX MILE CYPRESS PKWY
FORT MYERS, FL 33912-4314
Phone: (239) 479-6411 Fax: (239) 768-2032
Mailing address
618 SE 3RD ST
CAPE CORAL, FL 33990-1109
Phone: (239) 292-7669 Fax:
Sole Proprietor
Yes
Updated
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
2083S0010X
- Preventive Medicine / Sports Medicine (Primary)
FL AL2986

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.