| Doctor Name: | JEFFREY LUKE JACKSON |
| NPI Number: | 1548412992 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | DPM |
| License Number: | PO3675 |
| Business Practice Address: | 1677 Eagle Harbor Pkwy Suite C Fleming Island, FL - 320034802 |
| Business Phone Number: | 9042785112 |
| Business Fax Number: | 9042785874 |
| Mailing Address: | 1677 Eagle Harbor Pkwy C, FLEMING ISLAND |
| State: | FL |
| Postal Code: | 320034802 |
| Phone Number: | 9042785112 |
| Fax Number: | 9042785874 |
| NPI Enumeration Date: | 10/16/2008 |
| NPI Last Update Date: | 10/05/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 213ES0103X |
| License Number: | PO3675 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | FL |
| Taxonomy Type: | Podiatric Medicine & Surgery Service Providers |
| Taxonomy Classification: | Podiatrist |
| Taxonomy Specialization: | Foot & Ankle Surgery |
| Taxonomy Definition: | |