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J. PHILLIP JACKSON M.D.
NPI 1881675080
Family Medicine in Fort Wayne, IN

Active since November 07, 2005
7980 W JEFFERSON BLVD, FORT WAYNE, IN 46804(260) 436-9454(260) 436-7836 Get Directions Write a Review

NPPES record last updated: February 22, 2013. Verified against the NPPES registry weekly; last sync: July 19, 2026.

About J. Phillip Jackson M.d. NPPES

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

J. PHILLIP JACKSON M.D. (NPI 1881675080) is an individual family medicine provider in Fort Wayne, Indiana, licensed in Indiana (01037752A) and active in the NPI registry since November 2005.

NPPES Registry Identity

NPI1881675080
Entity TypeIndividualMale
Primary Taxonomy207Q00000X
Provider Legal NameJ. PHILLIP JACKSONCredential: M.D.
Location Address7980 W JEFFERSON BLVDFort Wayne, IN 46804-4170
Mailing Address3534 Brooklyn AveFort Wayne, IN 46809-1361 · (260) 747-6171 · Fax (260) 478-5125
Phone(260) 436-9454
Fax(260) 436-7836
Sole ProprietorNo
Enumeration DateNovember 7, 2005
Last NPPES UpdateFebruary 22, 2013
✔ NPI 1881675080 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
License✔ Licensed in IN · 01037752A
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.

7980 W JEFFERSON BLVD, Fort Wayne, IN 46804
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Other Identifiers 9

Other000000000892Mplan
Other080121955IN · Railroad Medicare
Medicare PINM400048217IN
Other1431Physicians Health Plan
Other000000091890Blue Cross Blue Shield
Medicare UPINE11385
Medicare PIN925500OIN
Medicare PIN925510BIN
Medicaid100462820IN

Other Providers at the Same Location NPPES 8

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

BROOKLYN MEDICAL ASSOCIATES LLC
Family Medicine
7980 W JEFFERSON BLVD
FORT WAYNE, IN 46804
Allen County (260) 747-6171
EMMANUEL C. CABE MD
Family Medicine
7980 W JEFFERSON BLVD
FORT WAYNE, IN 46804
Allen County (260) 436-6765
DAVID J. PARIS M.D.
Family Medicine
7980 W JEFFERSON BLVD
FORT WAYNE, IN 46804
Allen County (260) 478-5280
LEEANN K. PATTERSON DNP
Nurse Practitioner (Family)
7980 W JEFFERSON BLVD
FORT WAYNE, IN 46804
Allen County (260) 478-5220
JEFFREY P. LEVENDA MD
Family Medicine (Sports Medicine)
7980 W JEFFERSON BLVD
FORT WAYNE, IN 46804
Allen County (260) 478-5210
STEVEN MICHAEL PARIS DO
Family Medicine
7980 W JEFFERSON BLVD
FORT WAYNE, IN 46804
Allen County (260) 478-4205
LUTHERAN MEDICAL GROUP LLC
Durable Medical Equipment & Medical Supplies
7980 W JEFFERSON BLVD
FORT WAYNE, IN 46804
Allen County (260) 459-1587
DAVID E LENTZ DO
Family Medicine
7980 W JEFFERSON BLVD
FORT WAYNE, IN 46804
Allen County (260) 478-5160

Frequently Asked Questions

What is J. Jackson's NPI number?

The NPI number assigned to this healthcare provider is 1881675080, enumerated as an "individual" on November 07, 2005.

Where is the provider located?

The provider is located at 7980 W JEFFERSON BLVD FORT WAYNE, IN 46804 and the phone number is (260) 436-9454.

What is the provider's specialty?

Family Medicine with taxonomy code 207Q00000X.

What insurance does J. Jackson accept?

The provider might be accepting Accepts: Medicare, Medicaid, Railroad Medicare and Blue. Please consult your insurance carrier or call the provider to verify.