RICHARD JACKSON (NPI# 1124240197) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1124240197 |
| Entity Type | Individual |
| Full Name | RICHARD JACKSON |
| Practice Address |
2650 West 2700 South Syracuse UT 84075 |
| Practice Telephone | 8017730200 |
| Enumeration Date | 2007-05-02 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103TR0400X |
Psychologist Specialization: Rehabilitation |
Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629520770 | Richard Allen Jackson | Social Worker | 201 W Laurel St, Brainerd, MN 56401-3902 | 2016-10-25 |
| 1386924363 | Richard Ray Jackson | Social Worker | 104 S Ridge Ave, Troy, OH 45373-2704 | 2011-08-23 |
| 1508081993 | Richard Jackson | Psychiatry & Neurology | E 4111 Andover Road Suite 220, Bloomfield Hills, MI 48302 | 2007-04-13 |
| 1851478101 | Richard Jackson | Pharmacist | 420 Delaware St Se # Mmc812, Minneapolis, MN 55455-0341 | 2006-11-01 |
| 1972616134 | Richard Pharus Jackson | Optometrist | 216 W Washington St, Anthony, TX 79821-9304 | 2006-08-15 |
| 1801810163 | Richard Edwin Jackson | Dentist | 109 Timbermill Dr, Lexington, SC 29073-7138 | 2006-07-27 |
| 1366483406 | Richard D Jackson | Family Medicine | 29 Eastbrook Rd, Ronks, PA 17572-9769 | 2006-06-09 |
| 1659328060 | Richard Jackson | Emergency Medicine | 505 Regency Xing, Southlake, TX 76092-9501 | 2006-05-30 |
| 1174587505 | Richard E Jackson | Physician Assistant | 21260 Olean Blvd Ste 200, Port Charlotte, FL 33952-6742 | 2006-04-13 |
| 1629046339 | Richard K Jackson | Dentist | 1975 Sansburys Way Ste 112, West Palm Beach, FL 33411-1928 | 2006-03-09 |
| Street Address |
2650 WEST 2700 SOUTH |
| City | SYRACUSE |
| State | UT |
| Zip Code | 84075 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750775235 | Syracuse Assisted Living Phase I | Assisted Living Facility | 2063 W. 1900 S., Syracuse, UT 84075 | 2015-03-24 |
| 1881975464 | Norman Kent Sharp II | Dentist | 1662 S 2000 W Ste A1, Syracuse, UT 84075 | 2011-09-08 |
| 1245471705 | Ihc Health Services Inc | Family Medicine | 745 South 2000 West, Syracuse, UT 84075 | 2009-03-13 |
| 1679799902 | Nathan Wesley Elmore | Chiropractor | 1842 South 2000 West, Syracuse, UT 84075 | 2007-04-17 |
| 1972635332 | Aspen Institute for Behavioral Assessment | Psychiatric Residential Treatment Facility | 2732 W 2700 S, Syracuse, UT 84075 | 2007-03-12 |
| 1427111558 | Sheldon L Peck | Dentist | 1747 S Heritage Lane, Suite A3, Syracuse, UT 84075 | 2006-12-19 |
| 1811081771 | Tyler R Elmore | Chiropractor | 1013 W 2700 S, Syracuse, UT 84075 | 2006-10-03 |
| 1235247438 | Brett R Coleman | Dentist | 780 S 2000 W, Bldg E304, Syracuse, UT 84075 | 2006-08-28 |
| 1164431177 | Kipton Jay Norris | Dentist | 1747 S. Heritage Ln, Suite B-201, Syracuse, UT 84075 | 2006-08-07 |
| 1619982303 | Newell Taft | Counselor | 2512 West 1700 South, Syracuse, UT 84075 | 2006-07-30 |
| Find all providers in zip 84075 | ||||
| Taxonomy Code | 103TR0400X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Rehabilitation |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700438231 | J Quyen Vu Alexander Nichols | Psychologist | 50 N Medical Dr, Salt Lake City, UT 84132-0001 | 2019-07-15 |
Please comment or provide details below to improve the information on RICHARD JACKSON.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.