RUSSELL B JACKSON (NPI# 1922008663) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1922008663 |
| Entity Type | Individual |
| Full Name | RUSSELL B JACKSON |
| Credential | OD |
| Practice Address |
210 S 100 E Fillmore UT 84631-2500 |
| Mailing Address |
Po Box 73 Fillmore UT 84631-0073 |
| Practice Telephone | 4357436572 |
| Practice Fax Number | 4357435558 |
| Mailing Telephone | 4357436572 |
| Mailing Fax Number | 4357435558 |
| Enumeration Date | 2005-07-22 |
| Last Update Date | 2007-12-05 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 152W00000X | Optometrist | 375344-9934 | UT | Eye and Vision Services Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| UT | BLUE CROSS | 37534499300001 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699322578 | Russell Patrick Jackson | Student in an Organized Health Care Education/Training Program | 7311 E Southern Ave Apt 3064, Mesa, AZ 85209-2723 | 2019-08-24 |
| 1932622867 | Russell Emanuel Jackson | Specialist/Technologist | 2115 Mellwood Ct, Toledo, OH 43613-3407 | 2017-07-23 |
| 1073752879 | Russell Brent Jackson | Orthopaedic Surgery | 155 E Sonterra Blvd Ste 111, San Antonio, TX 78258-3988 | 2009-02-18 |
| 1396218418 | Russell L Jackson | Case Manager/Care Coordinator | 3500 Carnegie Ave, Cleveland, OH 44115-2641 | 2019-01-11 |
| 1902225519 | Russell Jackson | Physical Therapist | 1551 N Main St, Payson, UT 84651-5015 | 2014-04-10 |
| 1447406871 | Russell C Jackson | Case Manager/Care Coordinator | 715 N College Ave, El Dorado, AR 71730-4403 | 2008-08-18 |
| 1164576476 | Russell Earl Jackson | Counselor | 920 Boone St, Tupelo, MS 38804-5908 | 2007-01-23 |
| 1295895712 | Russell Jackson | Anesthesiology | 8700 Beverly Blvd, Suite 8211, West Hollywood, CA 90048-1804 | 2006-12-12 |
| 1457339517 | Russell Jackson | Radiology | 55 Fogg Rd, South Weymouth, MA 02190-2432 | 2006-01-08 |
| Street Address |
210 S 100 E |
| City | FILLMORE |
| State | UT |
| Zip Code | 84631-2500 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912181967 | Jackson Eye Care, Inc | Optometrist | 210 S 100 W, Fillmore, UT 84631 | 2007-12-27 |
| 1275726788 | Delta Physical Therapy and Sports Medicine PC | Occupational Therapist | 770 S Highway 99, Suite A, Fillmore, UT 84631 | 2007-08-20 |
| 1205957586 | Marilee Wood | Counselor | 65 West Center, Fillmore, UT 84631 | 2007-04-03 |
| 1124148424 | Merla Rutherford | Counselor | 65 W Center, Fillmore, UT 84631 | 2007-03-30 |
| 1609901818 | Linda Stephenson | Registered Nurse | 50 South 400 West, Fillmore, UT 84631 | 2007-02-21 |
| 1750466678 | Jan Bruce Beckstrand | Dentist | 140 South Main Street, Fillmore, UT 84631 | 2006-10-26 |
| 1023025939 | Jon Y. Moody | Dentist | 55 S Main, #3, Fillmore, UT 84631 | 2006-08-02 |
| 1710993506 | Central Utah Mental Health Substance Abuse | Counselor | 65 West Center Street, Fillmore, UT 84631 | 2006-07-31 |
| 1467865840 | Scott Robert Allen | Physical Therapist | 770 S Highway 99, Fillmore, UT 84631 | 2014-06-03 |
| 1851632095 | Jacob D Finlinson, D.d.s, LLC | Dentist | 140 South Main, Fillmore, UT 84631 | 2013-03-13 |
| Find all providers in zip 84631 | ||||
| Taxonomy Code | 152W00000X |
| Grouping | Eye and Vision Services Providers |
| Classification | Optometrist |
| Doctors of optometry (ODs) are the primary health care professionals for the eye. Optometrists examine, diagnose, treat, and manage diseases, injuries, and disorders of the visual system, the eye, and associated structures as well as identify related systemic conditions affecting the eye. An optometrist has completed pre-professional undergraduate education in a college or university and four years of professional education at a college of optometry, leading to the doctor of optometry (O.D.) degree. Some optometrists complete an optional residency in a specific area of practice. Optometrists are eye health care professionals state-licensed to diagnose and treat diseases and disorders of the eye and visual system. |
| Notes: Source: American Optometric Association (AOA), approved by the AOA’s Board of Trustees, June 21, 2005. [7/1/2006: definition modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912181967 | Jackson Eye Care, Inc | Optometrist | 210 S 100 W, Fillmore, UT 84631 | 2007-12-27 |
| 1336202225 | Heritage Valley Eye Care Optometric Center | Optometrist | 414 Central Ave, Fillmore, CA 93015-1330 | 2006-12-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396351383 | National Vision Inc | Optometrist | 3857 West Campus View Drive, Suite 110, West Jordan, UT 84084 | 2020-09-16 |
| 1104443159 | National Vision Inc | Optometrist | 1917 W 1800 N Ste D1, Clinton, UT 84015-8558 | 2020-06-25 |
| 1295350247 | Victoria Nielsen | Optometrist | 4934 S Plymouth View Dr, Taylorsville, UT 84123-4204 | 2020-06-15 |
| 1124643226 | Desert View Eyecare | Optometrist | 15 South River Road St. 150, St. George, UT 84790 | 2020-06-15 |
| 1013532894 | Meagan Miles | Optometrist | 1752 W 400 N Apt B, Salt Lake City, UT 84116-3546 | 2020-06-08 |
| 1669096020 | Thomas Edward Clark | Optometrist | 3672 W South Jordan Pkwy Ste 103, South Jordan, UT 84009-7172 | 2020-06-02 |
| 1225651011 | Bethany Ruth Gillett | Optometrist | 3029 S Colt Plaza Dr Ste 1, West Valley City, UT 84128-4015 | 2020-05-27 |
| 1881217446 | Collin Robert Gray | Optometrist | 75 W State St, Lehi, UT 84043-1546 | 2020-05-18 |
| 1841820792 | Clifford Parker | Optometrist | 4283 Harrison Blvd, Ogden, UT 84403-3101 | 2020-01-20 |
| 1598303075 | Choice Eye Center, LLC | Optometrist | 12272 S 800 E Ste 100a, Draper, UT 84020-9776 | 2019-12-16 |
| Find all providers with the same taxonomy | ||||
Please comment or provide details below to improve the information on RUSSELL B 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.