Robert M Jackson, M.D.

Primary specialty

Otolaryngology PhysicianTaxonomy code 207Y00000X

License

G50418 Issued in CA

Legal business name

ROBERT M JACKSON, M.D.

Practice address

41250 12TH St W Ste C
Palmdale, CA 93551-1444

Phone

(661) 224-1300

Fax

(661) 224-1333

NPI assigned

Feb 13, 2015

Organization subpart

No

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

Authorized official

Name

Mrs. Judy Ann Jackson

Title

Office Manager

Phone

(661) 224-1300

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Andrew Nixon, AU.D

  • Audiologist-Hearing Aid Fitter
  • Valencia, CA
  • NPI 1386996320
  NPD (past)

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

{
    "created_epoch": "1423785600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1423785600000",
    "number": "1457742306",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "41250 12TH ST W STE C",
            "city": "PALMDALE",
            "state": "CA",
            "postal_code": "935511444",
            "telephone_number": "661-224-1300",
            "fax_number": "661-224-1333"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "41250 12TH ST W STE C",
            "city": "PALMDALE",
            "state": "CA",
            "postal_code": "935511444",
            "telephone_number": "661-224-1300",
            "fax_number": "661-224-1333"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROBERT M JACKSON, M.D.",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-02-13",
        "last_updated": "2015-02-13",
        "status": "A",
        "authorized_official_last_name": "JACKSON",
        "authorized_official_first_name": "JUDY",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "661-224-1300",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Otolaryngology",
            "state": "CA",
            "license": "G50418",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE ID",
            "identifier": "W14331",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Olga G Rivero
• Ryan Garrett Roback, M.A.
• Nicole Robbins
• T'Azane Imani Louise Roberson
• Robert Haze DDS, Inc.
• Kay Dee Roberts, PA
• Sarah Robertson, NP
• Catrina Taylor Robin
• Alvan S Robinson Jr.
• Ayeisha A Robinson, LVN

• Otolaryngology Physician in Palmdale, CA
• Providers in Palmdale, CA by specialty
• Otolaryngology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 2015; 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.