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Search › Oregon › 207Q00000X

Larry Jackson, M.D

NPI 1578880548 · on the registry since 2010

Practice

Address
1445 Gateway Blvd
Cottage Grove, OR 97424
Phone
(541) 942-7000
Fax
(541) 942-5550
Organisation at this address
Icco Llc
Icco, Llc
Gateway Counseling Center, P.C.
Covered Bridge Physical Therapy Llc
Inferred from a shared address, not stated in the registry.
Clinicians at this address
10

Registry record

Primary taxonomy
207Q00000X
207Q00000X
Licence states on file
OR
From the registry's licence fields, which are often incomplete.
Sex
Male
Record last updated
2010-04-29

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 Oregon