person
Dr. Edward A Jackson, MD
Family Medicine Physician in Orlando, Florida
NPI 1639104029

Edward A Jackson is a Family Medicine Physician based in Orlando, FL. Edward A Jackson practices in Orlando, FL and has the professional credentials of MD. The NPI Number for Edward A Jackson is 1639104029 and holds a License No. 4301046128 (Florida).

The current practice location address for Edward A Jackson is 7975 Lake Underhill Rd Ste 200, Orlando, FL and can be reached out via phone at 407-303-6830 and via fax at 407-303-8659.

Location: 7975 Lake Underhill Rd Ste 200, Orlando, FL, 32822-8204
person
Provider Profile Details
NPI Number
1639104029
Provider Name
Edward A Jackson
Credential
MD
Provider Entity Type
Individual
Gender
Male
Address
7975 Lake Underhill Rd Ste 200, Orlando, FL, 32822-8204
Phone Number
407-303-6830
Fax Number
407-303-8659
Provider Enumeration Date
07/12/2006
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
101977 01 MI GREAT LAKES HEALTH PLAN
381870664 01 MI PRIORITY HEALTH
381870664 01 MI PRIVATE HEALTHCARE SYSTE
381870664112 01 MI COMMUNITY CHOICE MICHIGAN
0730985 01 MI BCBSM PIN
381870664 01 MI PPOM
080G376200 01 MI BCBSM GROUP NUMBER
1639104029 05 MI
EJ046128 01 MI LICENSE
0G37620004 01 MI RAILROAD MEDICARE
381870664 01 MI HEALTH CARE ALLIANCE POOL
4045995 01 MI AETNA
institution
Provider Business Practice Location Address Details
Address
7975 Lake Underhill Rd Ste 200
City
State
Zip
32822-8204
Phone Number
407-303-6830
Fax Number
407-303-8659
person
Provider Business Mailing Address Details
Address
7975 Lake Underhill Rd Ste 200
City
State
Zip
32822-8204
Phone Number
407-303-6830
Fax Number
407-303-8659
person
Provider's Taxonomy Details 1
Type
Allopathic & Osteopathic Physicians
Classification
Family Medicine
Speciality
-
Taxonomy
License No.
4301046128 (Michigan)
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.
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