Active NPI 1457491037 Individual Practitioner Male Practitioner

Dr. Kenneth C Jackson , MD

Specialist • Warr Acres, OK

Professional Overview & Biography Verified Profile Summary

Dr. Kenneth Jackson, MD is a registered healthcare professional specializing in Specialist in Warr Acres, OK. Practice services are available at 7301 N COMANCHE AVE under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

7301 N Comanche Ave
Ou Physicians

Warr Acres, OK 731326646

Telephone 4057218090

Fax 4057228529

Associated Practice Facility / Clinic

🏢 Grand Prairie Pediatric And Allergy Clinic Facility NPI 1588716104

Specialty Benchmarks & Practice Insights

Comparative analytics for Specialist in Warr Acres, OK

Active Practitioner

Practitioner Clinical Experience

Active

City Avg: 10.5 Yrs

State Avg: 38.7 Yrs

Regional Practice Density

2 Specialists

Practicing in Warr Acres, OK (463 Statewide)

Telehealth Adoption Rate

0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount

67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

Specialist Primary Specialty

NUCC Taxonomy Code: 174400000X

State License OK 11030

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.

Additional State Medicaid & Healthcare Payer Identifiers

Commercial Insurance / Payer ID License

11030 (OK)

Practice Associates & Co-Workers

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

1 Associated Practitioners

Dr. Mary Stockett , MD

Pediatrics

NPI 1477553105

Doctor of Medicine (M.D.)

Career & Practice History Timeline

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

6 Historical Events

✅

NPI Profile Active June 21, 2012

NPI status registered as active in NPPES database

📍

Updated Practice Location June 21, 2012

Registered at 7301 N COMANCHE AVE, OU PHYSICIANS, WARR ACRES, OK 731326646 (Tel: 4057218090)

📍

Updated Business Mailing Address June 21, 2012

Registered at 7301 N COMANCHE AVE, WARR ACRES, OK 731326646 (Tel: 4057218090)

👤

Provider Name / Credentials Updated June 21, 2012

Recorded as KENNETH JACKSON, M.D.

🎓

Medical Taxonomy / Specialty Registered (Primary Specialty) June 21, 2012

Specialist (License #11030 in OK)

🟢

Initial NPI Registration & Enumeration February 06, 2007

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

0 Reviews

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NPI Administrative Meta

NPI Number: 1457491037

Entity Type:

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

Enumeration Date: February 06, 2007

Last Update: March 07, 2023

Sole Proprietor: No

Update or Correct Profile

Mailing Address

7301 N Comanche Ave

Warr Acres, OK 731326646

Phone: 4057218090

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

⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.