Larry a. Jackson, MD PC

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

License

08513 Issued in OR

Legal business name

LARRY A. JACKSON, MD PC

Practice address

1717 Centennial Blvd
Suite 7
Springfield, OR 97477-3378

Phone

(541) 726-0550

Fax

(541) 726-7485

NPI assigned

May 21, 2013

Organization subpart

No

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

Authorized official

Name

Dr. Larry Arthur Jackson, MD

Title

President

Phone

(541) 726-0550

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1369094400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1369094400000",
    "number": "1134565849",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1717 CENTENNIAL BLVD",
            "address_2": "SUITE 7",
            "city": "SPRINGFIELD",
            "state": "OR",
            "postal_code": "974773378",
            "telephone_number": "541-726-0550",
            "fax_number": "541-726-7485"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1717 CENTENNIAL BLVD",
            "address_2": "SUITE 7",
            "city": "SPRINGFIELD",
            "state": "OR",
            "postal_code": "974773378",
            "telephone_number": "541-726-0550",
            "fax_number": "541-726-7485"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LARRY A. JACKSON, MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-05-21",
        "last_updated": "2013-05-21",
        "status": "A",
        "authorized_official_last_name": "JACKSON",
        "authorized_official_first_name": "LARRY",
        "authorized_official_middle_name": "ARTHUR",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "541-726-0550",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "General Practice",
            "state": "OR",
            "license": "08513",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Miranda Dawn Lanning, MD
• Amalie Lantz, LCSW
• Finn Michael Lapierre, PT
• Fernanda Maria Lara Maldonado
• Richard L Lari, M.D.
• Amy Jo Larsen, FNP-C
• Robb Nels Larsen, MD
• Brian James Larson, CRNA
• George Martin Larson III, D.O.
• John W Larson, DMD

• General Practice Physician in Springfield, OR
• Providers in Springfield, OR by specialty
• General Practice Physician in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 2013; 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.