Individual provider · Type 1 NPI

Richard J. Jackson, MD

Pediatric Surgery Physician · Temple, TX

NPI number 1215027883 Active

Practice location

1901 SW H K Dodgen Loop
Temple, TX 76502-3500

Call (254) 935-4000 Map

Fax (254) 935-4111

Mailing address

PO Box 844658
Dallas, TX 75284-4658

Specialties and licenses

TaxonomyCodeLicense
Pediatric Surgery Physician 2086S0120XN-8271 (AR)
Pediatric Surgery Physician Primary 2086S0120XN3094 (TX)

Pediatric Surgery Physician: A surgeon with expertise in the management of surgical conditions in premature and newborn infants, children and adolescents.

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About NPI 1215027883

Richard J. Jackson, MD's National Provider Identifier is 1215027883, issued on Oct 13, 2006. The primary taxonomy on file is Pediatric Surgery Physician (2086S0120X), and the practice location is in Temple, TX. The record was last updated on Jun 8, 2021.