Kyle Jackson, MD, PHD
Surgery in Philadelphia, Pennsylvania
1164849352- Practice location
- 3400 Spruce Street, 4 Silverstein, Philadelphia, PA 10104-4206
- Phone
- 215-615-4949
- Fax
- 215-662-2244
- Last updated
- October 30, 2024
Kyle Jackson is a Surgery based in Philadelphia, PA. Kyle Jackson practices in Philadelphia, PA and has the professional credentials of MD, PHD. The NPI Number for Kyle Jackson is 1164849352 and holds a License No. MD485481 (PA). The current practice location address for Kyle Jackson is 3400 Spruce Street, 4 Silverstein, Philadelphia, PA 10104-4206 and can be reached out via phone at 215-615-4949 and via fax at 215-662-2244.
Provider Profile Details
- NPI Number
- 1164849352
- Provider Name
- Kyle Jackson
- Credential
- MD, PHD
- Provider Entity Type
- Individual
- Gender
- Male
- Address
- 3400 Spruce Street, 4 Silverstein, Philadelphia, PA 10104-4206
- Phone Number
- 215-615-4949
- Fax Number
- 215-662-2244
- Primary Taxonomy
- Surgery · 208600000X
- Sole Proprietor
- Yes
- Provider Enumeration Date
- March 25, 2014
- Last Update Date
- October 30, 2024
- Certification Date
- October 25, 2024
- NPI Status
- Active
Provider Business Practice Location Address Details
- Address
- 3400 Spruce Street
4 Silverstein
Philadelphia, PA 10104-4206 - City
- Philadelphia
- State
- Pennsylvania
- Zip
- 10104-4206
- Phone Number
- 215-615-4949
- Fax Number
- 215-662-2244
Provider Business Mailing Address Details
- Address
- 3400 Spruce Street
4 Silverstein
Philadelphia, PA 10104-4206 - City
- Philadelphia
- State
- PA
- Zip
- 10104-4206
- Phone Number
- 215-615-4949
- Fax Number
- 215-662-2244
License Information
- License Number
- MD485481
- License State
- PA
- Taxonomy
- Surgery · 208600000X · Primary
Legacy Identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| No legacy identifiers (Medicaid, Medicare or plan IDs) are on file for this provider. | |||
Other Surgery providers near Philadelphia, PA
View all Surgery providers in Philadelphia →Frequently Asked Questions
What is the NPI number of Kyle Jackson, MD, PHD?
The NPI number of Kyle Jackson, MD, PHD is 1164849352. It was assigned on March 25, 2014 and is currently active in the NPPES registry.
What is the specialty of Kyle Jackson, MD, PHD?
Kyle Jackson, MD, PHD is registered under the primary taxonomy Surgery (code 208600000X), licensed in PA under license number MD485481.
Where does Kyle Jackson, MD, PHD practice?
The practice location is 3400 Spruce Street, 4 Silverstein, Philadelphia, PA 10104-4206. The office can be reached at 215-615-4949 (phone) or 215-662-2244 (fax).
What is an NPI number?
A National Provider Identifier (NPI) is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS). It is used in HIPAA standard transactions.
How do I verify this NPI record?
This record is sourced from the public NPPES NPI Registry maintained by CMS. You can confirm it by searching NPI 1164849352 directly on the NPPES registry website.