Provider Demographics
NPI:1295778496
Name:JACKSON, ROBERT FRANKLIN (MD)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:FRANKLIN
Last Name:JACKSON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:9660 E 146TH ST STE 100
Mailing Address - Street 2:
Mailing Address - City:NOBLESVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:46060-3097
Mailing Address - Country:US
Mailing Address - Phone:765-662-8303
Mailing Address - Fax:177-733-3223
Practice Address - Street 1:9660 E 146TH ST STE 100
Practice Address - Street 2:
Practice Address - City:NOBLESVILLE
Practice Address - State:IN
Practice Address - Zip Code:46060-3097
Practice Address - Country:US
Practice Address - Phone:173-773-6677
Practice Address - Fax:317-773-3322
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-14
Last Update Date:2025-05-11
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IN01021177208600000X
IN01021177A208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery