Ian T. Jackson, M.D.

Primary specialty

Medical Specialty Clinic/CenterTaxonomy code 261QM2500X

Legal business name

IAN T. JACKSON, M.D.

Practice address

26850 Providence Pkwy
Ste 205
Novi, MI 48374-1213

Phone

(248) 465-5300

Fax

(248) 465-5301

NPI assigned

Feb 7, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Ian Thomas Jackson, M.D.

Title

Physicandirector

Phone

(248) 465-5300

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1170806400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1269216000000",
    "number": "1649310632",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26850 PROVIDENCE PKWY",
            "address_2": "STE 205",
            "city": "NOVI",
            "state": "MI",
            "postal_code": "483741213",
            "telephone_number": "248-465-5300",
            "fax_number": "248-465-5301"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26850 PROVIDENCE PKWY",
            "address_2": "STE 205",
            "city": "NOVI",
            "state": "MI",
            "postal_code": "483741213",
            "telephone_number": "248-465-5300",
            "fax_number": "248-465-5301"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IAN T. JACKSON, M.D.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-07",
        "last_updated": "2010-03-22",
        "status": "A",
        "authorized_official_last_name": "JACKSON",
        "authorized_official_first_name": "IAN",
        "authorized_official_middle_name": "THOMAS",
        "authorized_official_title_or_position": "PHYSICANDIRECTOR",
        "authorized_official_telephone_number": "248-465-5300",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Medical Specialty Clinic/Center in Novi, MI
• Providers in Novi, MI by specialty
• Medical Specialty Clinic/Center in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 2010; 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.