Dr. Ian Thomas Jackson , MD
Specialist • Novi, MI
Notice of NPI Deactivation & Inactive Practice Status
According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Dr. Ian Jackson has officially deactivated this NPI record and ceased active healthcare practice.
Professional Overview & Biography Verified Profile Summary
Dr. Ian Jackson, MD was a registered Specialist practicing in Novi, MI. Throughout an active medical career spanning 15 years, Dr. Jackson provided care at the practice location at 26850 PROVIDENCE PKWY until profile deactivation on 2020-09-30.
Practice Location & Contact Primary Location
26850 Providence Pkwy
Ste 205
Novi, MI 483741213
Specialty Benchmarks & Practice Insights
Comparative analytics for Specialist in Novi, MI
Practicing in Novi, MI (867 Statewide)
In-Person Office Visits Only
Under CMS Medicare Fee Schedule vs Standard Submitted Charges
Medical Specialties & State Licenses
NUCC Taxonomy Code: 174400000X
An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.
Practice Associates & Co-Workers
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Otolaryngology
Doctor of Medicine (M.D.)
Career & Practice History Timeline
Chronological log of verified NPI updates, location relocations, credentials, and registry changes
Record deactivated on September 30, 2020
NPI status registered as active in NPPES database
Registered at 26850 PROVIDENCE PKWY, STE 205, NOVI, MI 483741213 (Tel: 2484655300)
Registered at 26850 PROVIDENCE PKWY, STE 205, NOVI, MI 483741213 (Tel: 2484655300)
Recorded as IAN JACKSON, M.D.
Specialist (License #382953668 in MI)
First registered as active Individual Practitioner in NPPES Database.
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NPI Administrative Meta
Mailing Address
26850 Providence Pkwy, Ste 205
Novi, MI 483741213
Phone: 2484655300
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