Michael Jackson, OD

NPI 1215091723 · on the registry since 2006

Practice

Address: 1850 Adams St Ste 112
Mankato, MN 56001
Phone: (507) 387-6358
Fax: (507) 387-4166
Organisation at this address: Miracle Ear
Visionworks, Inc.
Grand St Paul Cvs Llc
Mankato Clinic Express, Llc
Inferred from a shared address, not stated in the registry.
Clinicians at this address: 8

Registry record

Primary taxonomy: 152W00000X
152W00000X
Licence states on file: MN
From the registry's licence fields, which are often incomplete.
Sex: Male
Record last updated: 2007-07-09

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Minnesota