Dennis Mark Jackson, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

70142 Issued in NM

Practice address

Msc06 3870 1 University of New Mexico
Unm Student Health Center
Albuquerque, NM 87131-0001

Phone

(505) 277-3136

Fax

(505) 277-5668

NPI assigned

Nov 20, 2006

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other names 1

• Dennis M Jackson Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1163980800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1073687372",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "MSC06 3870 1 UNIV OF NM",
            "address_2": "UNM STUDENT HEALTH CENTER",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871310001",
            "telephone_number": "505-277-3136",
            "fax_number": "505-277-5668"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "MSC06 3870 1 UNIVERSITY OF NEW MEXICO",
            "address_2": "UNM STUDENT HEALTH CENTER",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871310001",
            "telephone_number": "505-277-3136",
            "fax_number": "505-277-5668"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "DENNIS",
        "middle_name": "MARK",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-20",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NM",
            "license": "70142",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DENNIS",
            "last_name": "JACKSON",
            "middle_name": "M",
            "credential": "MD",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Colton Worth Jackson, PA-C
• Courtney Marie Jackson
• Dailey Jackson, OTD
• David Bradley Jackson, DO
• Deborah Rene Jackson
• Gail E Jackson, LISW
• Helen Lamar Jackson, PH.D.
• Jamie A Jackson, MD
• Janelle Jackson, PT,DPT
• Jason Jackson, BS

• Family Medicine Physician in Albuquerque, NM
• Providers in Albuquerque, NM by specialty
• Family Medicine Physician in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.