MARY J JACKSON MD
NPI 1609851443
Family Medicine in Manlius, NY

Q: What is Mary Jackson's NPI number?

The NPI number for Mary Jackson is 1609851443. It was assigned to this individual provider in the NPPES registry on December 14, 2005.

Q: What is Mary Jackson's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Q: When was this NPI record last updated?

The NPPES record for Mary Jackson was last updated on June 8, 2009. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 17 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since December 14, 2005

308 W SENECA ST, MANLIUS, NY 13104(315) 682-5080(315) 682-8847 Get Directions Write a Review

NPPES record last updated: June 8, 2009. Verified against the NPPES registry weekly; last sync: September 06, 2026.

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About Mary J Jackson Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MARY J JACKSON MD (NPI 1609851443) is an individual family medicine provider in Manlius, New York, licensed in New York (154924) and active in the NPI registry since December 2005.

NPPES Registry Identity

NPI1609851443

Entity TypeIndividualFemale

Primary Taxonomy207Q00000X

Provider Legal NameMARY J JACKSONCredential: MD

Location Address308 W SENECA STManlius, NY 13104-2318

Mailing Address1001 W Fayette St, Ste 400Syracuse, NY 13204-2859 · (315) 472-1488 · Fax (315) 472-8060

Phone(315) 682-5080

Fax(315) 682-8847

Sole ProprietorNo

Enumeration DateDecember 14, 2005

Last NPPES UpdateJune 8, 2009

✔ NPI 1609851443 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207Q00000X

License✔ Licensed in NY · 154924

Definition

Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

308 W SENECA ST, Manlius, NY 13104

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Other Identifiers 3

Medicare UPIND02331NY

Medicare PIN080094865NY

Medicare PIN56100INY

Other Providers at the Same Location NPPES 7

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

LORI L ANDERSON MD

Family Medicine