Active NPI 1730476730 Individual Practitioner Male Practitioner

Dr. Jared Jackson , MD

Ophthalmology • Edmond, OK

✓ Accepts Medicare Assignment

Professional Overview & Biography Verified Profile Summary

Dr. Jared Jackson, MD is a certified Ophthalmology practicing in Edmond, OK. With approximately 15 years of clinical experience since graduating from University Of Iowa, Rj & L Carver College Of Medicine in 2011, Dr. Jackson delivers high-quality medical care to the local community at 3431 S BOULEVARD STE 105.

Dr. Jackson maintains professional affiliations with Oklahoma Eye Institute, Eye Care Specialists Of Oklahoma Pllc and accepts Medicare assignment.

Frequently performed procedures and clinical services include established patient outpatient office visit, removal of cataract with insertion of lens, established patient complete exam of visual system. Full Medicare procedure pricing transparency rates and service volume details are listed on this profile.

Practice Location & Contact Primary Location

Practice Address

3431 S Boulevard Ste 105

Edmond, OK 730135514

Telephone 4057710880

Fax 4055622116

Associated Practice Facility / Clinic

🏢 Eye Care Specialists Of Oklahoma Pllc Facility NPI 1427556166

Medicare Profile & Education

Medical School

University Of Iowa, Rj & L Carver College Of Medicine

Graduation Year

2011

Medicare Assignment

✓ Accepts Assignment

Telehealth Flag

In-Person Only

Specialty Benchmarks & Practice Insights

Comparative analytics for Ophthalmology in Edmond, OK

Established Specialist (10-20 Yrs)

Practitioner Clinical Experience

15 Yrs -11.8 yrs vs City Avg

City Avg: 26.8 Yrs

State Avg: 30.8 Yrs

Regional Practice Density

17 Specialists

Practicing in Edmond, OK (217 Statewide)

Telehealth Adoption Rate

0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount

54.8% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Clinical Seniority & Experience Comparison

Dr. Jackson (15 Years) 15 Yrs

Edmond Specialty Average (26.8 Years) 26.8 Yrs

Performed Procedures & Service Volume

Top Medicare Part B procedures performed by this practitioner

CMS Official Data (2024)

Reporting Year:

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	284	215	$240.14	$118.78
66984 Removal of cataract with insertion of lens	266	151	$987.09	$448.15
92014 Established patient complete exam of visual system	208	196	$228.49	$114.84
92136 Measurement of corneal curvature and depth of eye	203	200	$143.81	$41.70
92285 Photography of content of eyes	192	180	$35.07	$20.37
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	185	185	$310.31	$154.41
92136 Measurement of corneal curvature and depth of eye	154	145	$110.53	$27.08
92133 Imaging of optic nerve	127	92	$67.17	$32.63
92081 Exam of visual field with limited testing	109	106	$50.52	$27.11
99213 Established patient office or other outpatient visit, typically 15 minutes	107	85	$169.18	$83.70
66821 Removal of recurring cataract in lens capsule using a laser	100	70	$611.81	$296.91
92134 Imaging of retina	91	86	$73.79	$34.95
92012 Established patient problem focused exam of visual system	86	81	$105.01	$80.73
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	77	66	$105.13	$51.32
15823 Removal of excessive skin and fat of upper eyelid	60	60	$2035.27	$730.38
92083 Exam of visual field with extended testing	44	40	$115.58	$56.96
67917 Extensive repair of turning-outward eyelid defect	38	38	$1011.56	$418.68
92004 New patient complete exam of visual system	33	33	$276.13	$136.43
92002 New patient problem focused exam of visual system	33	33	$100.77	$76.99
68840 Probing of nasal-tear duct	28	28	$288.51	$148.29
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	26	26	$204.02	$102.78
66982 Complex removal of cataract with insertion of prosthetic lens	24	17	$1287.28	$631.36
66991 Extracapsular removal of cataract with insertion of artificial lens and insertion of drainage device in front chamber of eye	21	11	$1192.63	$597.42
67840 Removal of eyelid growth	14	14	$407.08	$249.87
67900 Repair of brow paralysis	13	12	$1192.41	$449.30

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
66984 Removal of cataract with insertion of lens	302	174	$1073.84	$455.19
92014 Established patient complete exam of visual system	274	259	$222.71	$116.13
92136 Measurement of corneal curvature and depth of eye	220	210	$122.59	$42.77
92285 Photography of content of eyes	207	186	$47.66	$20.05
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	196	196	$303.25	$153.39
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	188	164	$234.36	$118.14
92136 Measurement of corneal curvature and depth of eye	162	149	$103.78	$28.31
92012 Established patient problem focused exam of visual system	135	123	$122.46	$81.81
92133 Imaging of optic nerve	130	98	$65.50	$33.14
92081 Exam of visual field with limited testing	127	122	$58.97	$27.39
66821 Removal of recurring cataract in lens capsule using a laser	114	88	$593.11	$303.77
92134 Imaging of retina	103	98	$69.15	$35.34
99213 Established patient office or other outpatient visit, typically 15 minutes	102	93	$149.61	$83.34
15823 Removal of excessive skin and fat of upper eyelid	96	96	$1695.76	$736.47
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	93	86	$89.83	$52.19
92083 Exam of visual field with extended testing	54	53	$114.67	$55.92
92004 New patient complete exam of visual system	52	52	$267.39	$138.58
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	40	40	$194.45	$104.23
67917 Extensive repair of turning-outward eyelid defect	38	37	$1054.31	$438.57
76514 Ultrasound scan of cornea to determine thickness	34	33	$23.72	$10.05
92002 New patient problem focused exam of visual system	33	33	$102.22	$77.04
67840 Removal of eyelid growth	26	25	$482.01	$255.62
67800 Removal of eyelid growth	25	19	$231.45	$115.97
66991 Extracapsular removal of cataract with insertion of artificial lens and insertion of drainage device in front chamber of eye	23	14	$1286.55	$593.46
99202 New patient office or other outpatient visit, typically 20 minutes	16	16	$131.30	$64.79
66982 Complex removal of cataract with insertion of prosthetic lens	16	13	$1759.52	$640.80
67900 Repair of brow paralysis	15	15	$1196.59	$363.07
92025 Ct scan of cornea	12	12	$61.93	$30.05

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
92012 Established patient problem focused exam of visual system	321	250	$131.12	$81.85
66984 Removal of cataract with insertion of lens	283	165	$1212.00	$467.69
92285 Photography of content of eyes	273	222	$54.62	$20.39
92014 Established patient complete exam of visual system	268	250	$211.00	$116.35
92136 Measurement of corneal curvature and depth of eye	216	199	$146.00	$45.74
92004 New patient complete exam of visual system	149	149	$257.24	$139.18
92133 Imaging of optic nerve	124	87	$62.56	$32.58
92136 Measurement of corneal curvature and depth of eye	114	112	$146.00	$28.74
92083 Exam of visual field with extended testing	95	91	$98.43	$56.24
92081 Exam of visual field with limited testing	91	89	$76.21	$27.57
15823 Removal of excessive skin and fat of upper eyelid	90	89	$1424.20	$731.02
66821 Removal of recurring cataract in lens capsule using a laser	88	64	$560.00	$281.21
92134 Imaging of retina	85	80	$63.00	$35.67
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	82	82	$297.00	$156.44
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	73	73	$191.00	$105.31
76514 Ultrasound scan of cornea to determine thickness	62	54	$25.00	$10.25
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	53	47	$75.60	$52.84
67917 Extensive repair of turning-outward eyelid defect	52	52	$1127.50	$486.05
92002 New patient problem focused exam of visual system	52	52	$98.87	$80.22
99211 Office or other outpatient visit for the evaluation and management of established patient that may not require presence of healthcare professional	36	29	$37.00	$21.19
83861 Microfluid analysis of tears	30	13	$23.58	$22.26
99213 Established patient office or other outpatient visit, typically 15 minutes	30	28	$130.10	$85.66
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	28	28	$192.00	$120.54
92025 Ct scan of cornea	22	21	$63.00	$30.84
67840 Removal of eyelid growth	21	21	$422.76	$267.87
67800 Removal of eyelid growth	19	17	$200.16	$109.55
68840 Probing of nasal-tear duct	16	13	$205.79	$144.15
66821 Removal of recurring cataract in lens capsule using a laser	14	14	$560.00	$287.20
67840 Removal of eyelid growth	13	13	$408.95	$81.52
14040 Repair of wound of forehead, cheeks, chin, mouth, neck, underarms, genitals, hands, or feet by transferring skin, 10.0 sq cm or less	11	11	$1207.60	$450.70

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
66984 Removal of cataract with insertion of lens	321	188	$1209.54	$481.21
92285 Photography of content of eyes	316	265	$52.75	$20.74
92012 Established patient problem focused exam of visual system	291	242	$119.69	$84.05
92136 Measurement of corneal curvature and depth of eye	279	252	$146.00	$49.56
92014 Established patient complete exam of visual system	258	233	$211.31	$119.67
92004 New patient complete exam of visual system	169	169	$256.69	$142.94
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	157	157	$297.00	$159.88
92136 Measurement of corneal curvature and depth of eye	148	143	$145.25	$30.58
92133 Imaging of optic nerve	136	107	$63.00	$33.71
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	121	121	$191.00	$106.16
92081 Exam of visual field with limited testing	115	108	$78.26	$29.35
92134 Imaging of retina	89	85	$62.47	$37.03
15823 Removal of excessive skin and fat of upper eyelid	83	82	$1378.73	$776.90
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	82	76	$192.00	$123.55
92083 Exam of visual field with extended testing	78	72	$98.25	$54.70
83861 Microfluid analysis of tears	66	33	$23.58	$22.48
67917 Extensive repair of turning-outward eyelid defect	55	55	$1037.86	$533.22
66821 Removal of recurring cataract in lens capsule using a laser	52	43	$554.19	$293.17
99213 Established patient office or other outpatient visit, typically 15 minutes	47	46	$128.00	$85.49
92020 Examination of cornea and iris using lens device and slit lamp	41	40	$50.00	$26.65
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	39	35	$75.45	$53.27
83516 Analysis of substance using immunoassay technique	38	19	$23.15	$11.53
92002 New patient problem focused exam of visual system	34	34	$99.99	$81.40
65855 Laser repair to improve eye fluid flow	27	22	$592.00	$195.87
76514 Ultrasound scan of cornea to determine thickness	26	23	$25.00	$10.56
66982 Complex removal of cataract with insertion of prosthetic lens	25	19	$1881.08	$612.15
67800 Removal of eyelid growth	18	18	$204.30	$118.57
67840 Removal of eyelid growth	18	16	$469.46	$278.70
92025 Ct scan of cornea	15	14	$63.00	$32.31
66821 Removal of recurring cataract in lens capsule using a laser	14	14	$542.99	$315.55
99211 Office or other outpatient visit for the evaluation and management of established patient that may not require presence of healthcare professional	11	11	$37.00	$21.21
67840 Removal of eyelid growth	11	11	$379.82	$74.42
68840 Probing of nasal-tear duct	11	11	$212.28	$130.91

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	242	184	$191.30	$104.66
92285 Photography of content of eyes	202	181	$53.38	$19.79
66984 Removal of cataract with insertion of lens	187	107	$1204.50	$498.12
92014 Established patient complete exam of visual system	169	166	$208.87	$120.59
92012 Established patient problem focused exam of visual system	156	131	$111.02	$82.89
92136 Measurement of corneal curvature and depth of eye	137	126	$146.00	$58.79
92133 Imaging of optic nerve	124	97	$62.84	$34.49
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	119	119	$191.00	$100.71
92004 New patient complete exam of visual system	106	106	$258.00	$142.94
99213 Established patient office or other outpatient visit, typically 15 minutes	100	76	$125.26	$72.01
92136 Measurement of corneal curvature and depth of eye	79	79	$144.55	$30.00
92083 Exam of visual field with extended testing	72	68	$98.40	$55.73
83861 Microfluid analysis of tears	70	35	$23.58	$22.36
92134 Imaging of retina	64	56	$62.69	$37.75
92081 Exam of visual field with limited testing	60	59	$92.09	$28.93
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	55	55	$297.00	$157.29
15823 Removal of excessive skin and fat of upper eyelid	53	53	$1405.68	$767.41
66821 Removal of recurring cataract in lens capsule using a laser	50	42	$560.00	$296.74
83516 Analysis of substance using immunoassay technique	50	25	$23.15	$11.46
92002 New patient problem focused exam of visual system	47	47	$101.45	$79.88
65855 Laser repair to improve eye fluid flow	39	27	$592.00	$201.91
67917 Extensive repair of turning-outward eyelid defect	39	39	$1031.93	$566.66
92020 Examination of cornea and iris using lens device and slit lamp	39	34	$50.00	$26.63
67840 Removal of eyelid growth	28	26	$390.20	$264.91
76514 Ultrasound scan of cornea to determine thickness	21	21	$25.00	$10.98
67800 Removal of eyelid growth	20	18	$210.58	$115.66
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	13	13	$76.00	$43.11

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
92012 Established patient problem focused exam of visual system	397	269	$132.43	$83.12
66984 Removal of cataract with insertion of lens	212	124	$1177.41	$598.32
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	186	186	$191.00	$102.91
92285 Photography of content of eyes	169	148	$56.91	$19.77
92014 Established patient complete exam of visual system	142	136	$208.90	$118.33
92136 Measurement of corneal curvature and depth of eye	139	131	$143.46	$63.38
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	122	96	$192.00	$103.82
92004 New patient complete exam of visual system	119	119	$256.16	$143.95
83861 Microfluid analysis of tears	98	46	$23.58	$22.03
92136 Measurement of corneal curvature and depth of eye	95	89	$132.75	$30.60
99213 Established patient office or other outpatient visit, typically 15 minutes	76	70	$128.00	$70.72
15823 Removal of excessive skin and fat of upper eyelid	74	74	$1436.02	$788.11
92081 Exam of visual field with limited testing	71	67	$94.02	$28.22
92083 Exam of visual field with extended testing	70	61	$84.23	$49.28
92134 Imaging of retina	61	55	$61.05	$37.25
66821 Removal of recurring cataract in lens capsule using a laser	59	43	$560.00	$286.52
92133 Imaging of optic nerve	58	52	$62.32	$34.50
83516 Analysis of substance using immunoassay technique	56	26	$23.15	$12.55
67917 Extensive repair of turning-outward eyelid defect	54	53	$1119.91	$531.17
92020 Examination of cornea and iris using lens device and slit lamp	54	44	$50.00	$26.49
92002 New patient problem focused exam of visual system	52	52	$99.04	$78.21
0191T Internal insertion of eye fluid drainage device	30	17	$1980.00	$317.52
0376T Insertion of eye drainage device	26	15	$600.00	$158.76
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	23	23	$285.45	$152.50
65855 Laser repair to improve eye fluid flow	22	13	$592.00	$201.81
67800 Removal of eyelid growth	21	21	$206.54	$116.66
67908 Removal of tissue, muscle, and membrane to correct eyelid drooping or paralysis	21	21	$987.03	$463.78
68840 Probing of nasal-tear duct	18	18	$226.17	$133.27
67840 Removal of eyelid growth	17	17	$422.74	$262.26
67900 Repair of brow paralysis	14	14	$1218.63	$439.14
67810 Biopsy of eyelid	14	14	$361.92	$159.10
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	13	11	$76.00	$42.70
14040 Repair of wound of forehead, cheeks, chin, mouth, neck, underarms, genitals, hands, or feet by transferring skin, 10.0 sq cm or less	12	12	$1114.06	$462.82

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
92012 Established patient problem focused exam of visual system	310	201	$120.70	$81.43
92136 Measurement of corneal curvature and depth of eye	201	141	$139.14	$53.80
66984 Removal of cataract with insertion of lens	192	115	$1345.59	$594.54
92014 Established patient complete exam of visual system	168	162	$170.00	$117.94
92004 New patient complete exam of visual system	147	147	$243.74	$140.59
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	105	105	$191.00	$100.86
92285 Photography of content of eyes	70	66	$69.79	$17.12
99213 Established patient office or other outpatient visit, typically 15 minutes	63	52	$126.23	$68.14
92002 New patient problem focused exam of visual system	56	56	$114.47	$77.64
92134 Imaging of retina	52	52	$72.35	$37.48
92133 Imaging of optic nerve	52	47	$74.04	$34.92
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	51	50	$190.32	$100.63
92083 Exam of visual field with extended testing	46	46	$104.27	$58.18
92020 Examination of cornea and iris using lens device and slit lamp	42	37	$49.44	$25.44
66821 Removal of recurring cataract in lens capsule using a laser	38	30	$597.89	$286.83
83861 Microfluid analysis of tears	36	17	$28.02	$22.03
15823 Removal of excessive skin and fat of upper eyelid	36	36	$1605.65	$699.21
92081 Exam of visual field with limited testing	35	35	$94.27	$31.80
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	25	25	$286.37	$156.64
67917 Extensive repair of turning-outward eyelid defect	23	23	$1319.33	$461.45
92136 Measurement of corneal curvature and depth of eye	21	19	$118.76	$30.20
76514 Ultrasound scan of cornea to determine thickness	20	20	$28.51	$13.91
67840 Removal of eyelid growth	14	14	$425.10	$256.82
68840 Probing of nasal-tear duct	13	12	$227.23	$116.22
67908 Removal of tissue, muscle, and membrane to correct eyelid drooping or paralysis	12	12	$947.63	$311.08

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
92014 Established patient complete exam of visual system	713	659	$140.00	$114.73
92012 Established patient problem focused exam of visual system	481	308	$94.96	$78.15
92136 Measurement of corneal curvature and depth of eye	244	151	$115.00	$60.16
66984 Removal of cataract with insertion of lens	231	133	$2000.00	$582.67
92004 New patient complete exam of visual system	196	196	$190.00	$138.39
92134 Imaging of retina	167	149	$89.73	$37.55
92133 Imaging of optic nerve	137	125	$89.67	$34.27
83861 Microfluid analysis of tears	105	50	$35.00	$22.21
92285 Photography of content of eyes	100	100	$75.00	$17.57
66821 Removal of recurring cataract in lens capsule using a laser	82	65	$800.00	$288.16
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	67	67	$145.00	$101.25
92250 Photography of the retina	61	57	$120.00	$59.56
92083 Exam of visual field with extended testing	37	36	$100.00	$57.85
92081 Exam of visual field with limited testing	31	31	$125.00	$31.11
67840 Removal of eyelid growth	27	27	$525.00	$233.91
92002 New patient problem focused exam of visual system	26	26	$105.00	$75.18
15823 Removal of excessive skin and fat of upper eyelid	26	26	$1700.00	$600.62
68840 Probing of nasal-tear duct	22	21	$350.00	$126.06
67917 Extensive repair of turning-outward eyelid defect	21	20	$1157.14	$419.72
92020 Examination of cornea and iris using lens device and slit lamp	18	17	$50.00	$25.23
76514 Ultrasound scan of cornea to determine thickness	18	18	$45.00	$13.45
68761 Closure of tear duct opening using plug	16	14	$300.00	$142.56
67800 Removal of eyelid growth	14	14	$275.00	$104.87

Medical Specialties & State Licenses

CMS Verified: 2020-04-21

Ophthalmology Primary Specialty

NUCC Taxonomy Code: 207W00000X

State License OK 29168

An ophthalmologist has the knowledge and professional skills needed to provide comprehensive eye and vision care. Ophthalmologists are medically trained to diagnose, monitor and medically or surgically treat all ocular and visual disorders. This includes problems affecting the eye and its component structures, the eyelids, the orbit and the visual pathways. In so doing, an ophthalmologist prescribes vision services, including glasses and contact lenses.

Clinic/Center - Medical Specialty

NUCC Taxonomy Code: 261QM2500X

State License OK 29168

An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to a specific area of medical specialization. Frequently used for Title V related Children's Specialty services or to meet specific public health needs (e.g., infectious diseases or breast and cervical cancer).

Student in an Organized Health Care Education/Training Program

NUCC Taxonomy Code: 390200000X

State License IN 11016020A

An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

Additional State Medicaid & Healthcare Payer Identifiers

Medicaid State Provider ID

200752480A (OK)

Hospital & Practice Group Affiliations

Eye Care Specialists Of Oklahoma Pllc

3431 S Boulevard, Edmond, OK 730135514

Phone: 4055622036

Oklahoma Eye Institute

5370 Nw Cache Rd, Lawton, OK 735053371

Phone: 5805360000

Secondary Practice Locations

2150 S Douglas Blvd Ste C

Midwest City, OK 731306200

Phone: 4057710880

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

3 Associated Practitioners

Dr. Thomas Wolf , MD

Ophthalmology

NPI 1124088067

Doctor of Medicine (M.D.)

Dr. Austin Lagrow , MD

Ophthalmology

NPI 1508489956

Doctor of Medicine (M.D.)

Dr. Virgil Shepherd , MD

Ophthalmology

NPI 1588671408

Doctor of Medicine (M.D.)

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

12 Historical Events

📍

Updated Business Mailing Address April 26, 2018

Registered at PO BOX 1803, EDMOND, OK 730831803 (Tel: 4054184800)

✅

NPI Profile Active January 29, 2018

NPI status registered as active in NPPES database

📍

Updated Practice Location January 29, 2018

Registered at 3431 S BOULEVARD STE 105, EDMOND, OK 730135514 (Tel: 4055622036)

📍

Updated Business Mailing Address January 29, 2018

Registered at PO BOX 271445, OKLAHOMA CITY, OK 731371445 (Tel: 4054184800)

👤

Provider Name / Credentials Updated January 29, 2018

Recorded as JARED JACKSON, M.D.

🎓

Medical Taxonomy / Specialty Registered (Primary Specialty) January 29, 2018

Ophthalmology (License #29168 in OK)

✅

NPI Profile Active June 29, 2011

NPI status registered as active in NPPES database

📍

Updated Practice Location June 29, 2011

Registered at 1633 N CAPITOL AVE, INDIANAPOLIS, IN 462021261 (Tel: 3179628881)

📍

Updated Business Mailing Address June 29, 2011

Registered at 1633 N CAPITOL AVE, INDIANAPOLIS, IN 462021261 (Tel: 3179628881)

👤

Provider Name / Credentials Updated June 29, 2011

Recorded as JARED JACKSON, M.D.

🎓

Medical Taxonomy / Specialty Registered (Primary Specialty) June 29, 2011

Student in an Organized Health Care Education/Training Program (License #11016020A in IN)

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Initial NPI Registration & Enumeration June 29, 2011

First registered as active Individual Practitioner in NPPES Database.

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NPI Administrative Meta

NPI Number: 1730476730

Entity Type:

Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)

Enumeration Date: June 29, 2011

Last Update: April 21, 2020

Sole Proprietor: Yes

Update or Correct Profile

Mailing Address

Po Box 1803

Edmond, OK 730831803

Phone: 4054184800

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).

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