National Provider Identifier
Mark Franklin Jackson, P.T., DPT, MPS, OCS
Mark Franklin Jackson, P.T., DPT, MPS, OCS is listed in the NPPES registry with a primary specialty of Physical Therapist in Ithaca, NY and a listed phone number of (607) 274-4159.
Profile Overview
- NPI
- 1467504365
- Provider Type
- Individual
- Primary Specialty
- Physical Therapist
- Enumeration Date
- January 18, 2007
- Last Updated
- February 27, 2012
Practice Location
- 10 Brentwood Dr
- Suite A
- Ithaca, NY 14850-1865
Phone: (607) 274-4159
Mailing Address
- 39 Evergreen St
- Cortland, NY 13045-1109
Specialties
- Physical Therapist (225100000X)
Full Record
- NPI
- 1467504365
- Entity Type
- Individual
- Last Name
- Jackson
- First Name
- Mark
- Middle Name
- Franklin
- Credential
- P.T., DPT, MPS, OCS
- Mailing Street Address
- 39 Evergreen St
- Mailing City
- Cortland
- Mailing State
- NY
- Mailing ZIP Code
- 13045-1109
- Mailing Country
- US
- Mailing Phone
- (607) 423-7509
- Practice Street Address
- 10 Brentwood Dr
- Practice Address Line 2
- Suite A
- Practice City
- Ithaca
- Practice State
- NY
- Practice ZIP Code
- 14850-1865
- Practice Country
- US
- Practice Phone
- (607) 274-4159
- Practice Fax
- (607) 274-4675
- Enumeration Date
- January 18, 2007
- Last Updated
- February 27, 2012
- Sex
- Male
- Sole Proprietor
- No
- updated_by_file
- npidata_pfile_20050523-20260308.csv
- Taxonomies
- Physical Therapist (225100000X)
- Other Identifiers
- 000142682 (NY, Excellus BCBS), 7475387 (NY, Aetna US Healthcare), 4123843 (NY, Mvp)