Daniel G Jackson, M.D.

Primary specialty

Otolaryngology/Facial Plastic Surgery PhysicianTaxonomy code 207YX0905X

License

35036563 Issued in OH

Practice address

1810 Mackenzie Dr
Columbus, OH 43220-2967

Phone

(614) 273-2250

Fax

(614) 273-2255

NPI assigned

Jul 22, 2005

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 identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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

{
    "created_epoch": "1121990400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1202428800000",
    "number": "1447250246",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "974 BETHEL RD",
            "address_2": "SUITE A",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432142467",
            "telephone_number": "614-538-2424",
            "fax_number": "614-538-2418"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1810 MACKENZIE DR",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432202967",
            "telephone_number": "614-273-2250",
            "fax_number": "614-273-2255"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "DANIEL",
        "middle_name": "G",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-22",
        "last_updated": "2008-02-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207YX0905X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Otolaryngology/Facial Plastic Surgery",
            "state": "OH",
            "license": "35036563",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000542269",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0254193",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ciera Jackson
• Clifton Jackson
• Colette Jackson
• Dakiesha Jackson
• Dana Lashelle Jackson, MSW, LSW
• Dantelle Jackson, QMHS
• Darel Jackson
• Deja Jackson
• Dejanae Jackson
• Devin M Jackson, QMHS-H

• Otolaryngology/Facial Plastic Surgery Physician in Columbus, OH
• Providers in Columbus, OH by specialty
• Otolaryngology/Facial Plastic Surgery Physician in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 8, 2008; 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.