DR. LESLIE W JACKSON (NPI# 1972690774) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1972690774 |
| Entity Type | Individual |
| Full Name | DR. LESLIE W JACKSON |
| Other Name | DR. LESLIE K WILGUS |
| Credential | MD |
| Practice Address |
3175 Pocahontas Rd Saint Alphonsus Medical Group Baker City Baker City OR 97814-1434 |
| Practice Telephone | 5415234415 |
| Practice Fax Number | 5415249027 |
| Mailing Telephone | 5415234415 |
| Mailing Fax Number | 5415249027 |
| Enumeration Date | 2006-10-05 |
| Last Update Date | 2013-01-29 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207RR0500X |
Internal Medicine Specialization: Rheumatology |
M-11620 | ID | Allopathic & Osteopathic Physicians |
| Y | 207RR0500X |
Internal Medicine Specialization: Rheumatology |
MD156467 | OR | Allopathic & Osteopathic Physicians |
| N | 207RR0500X |
Internal Medicine Specialization: Rheumatology |
9300627 | NC | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750851325 | Leslie Jackson | Nurse Practitioner | 7106 Spencer Highway, Pasadena, TX 77505 | 2018-11-27 |
| 1780076745 | Leslie Jackson | Chore Provider | 18350 Lahser Rd, Detroit, MI 48219-4326 | 2015-02-28 |
| 1952587271 | Leslie Cecilia Jackson | Psychologist | 734 Kenilworth Cir, Stone Mountain, GA 30083-3416 | 2008-01-16 |
| 1649320904 | Leslie K Jackson | Family Medicine | 404 E Main Cross St, Taylorville, IL 62568-2656 | 2007-01-11 |
| 1578171039 | Leslie D'layne Jackson | Social Worker | 43 N Cleveland St, Memphis, TN 38104-2301 | 2020-07-20 |
| 1497398218 | Leslie Denise Jackson | Advanced Practice Midwife | 1001 W Randol Mill Rd, Arlington, TX 76012-2513 | 2019-10-24 |
| 1699261826 | Leslie Aaron Jackson | Chiropractor | 7125 Marvin D Love Fwy Ste 107, Dallas, TX 75237-3111 | 2018-07-11 |
| 1669900239 | Leslie J Jackson | Social Worker | 650 Fulton St, Brooklyn, NY 11217-1517 | 2017-05-26 |
| 1083057152 | Leslie Schaad Jackson | Nurse Practitioner | 10515 Bells Ferry Rd Ste 200, Canton, GA 30114-4204 | 2013-04-09 |
| 1861753048 | Leslie L Jackson | Occupational Therapist | 9501 S King Dr, Dh 132, Chicago, IL 60628-1501 | 2012-06-04 |
| Street Address |
3175 POCAHONTAS RD SAINT ALPHONSUS MEDICAL GROUP BAKER CITY |
| City | BAKER CITY |
| State | OR |
| Zip Code | 97814-1434 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841253408 | Bud W Zunino | Nurse Practitioner | 3175 Pocahontas Rd, Baker City, OR 97814-1434 | 2006-04-06 |
| 1679943328 | Jonathan Wilson Clark | Occupational Therapist | 3175 Pocahontas Rd, Baker City, OR 97814-1434 | 2015-10-06 |
| 1568774362 | Derek Guy Zickgraf | Family Medicine | 3175 Pocahontas Rd, Baker City, OR 97814 | 2010-07-08 |
| 1699709253 | Jon Eric Petterson | Family Medicine | 3175 Pocahontas Rd, Baker City, OR 97814-1434 | 2006-07-10 |
| 1376577940 | Robert Menzie Mckim | Family Medicine | 3175 Pocahontas Rd, Baker City, OR 97814-1434 | 2006-07-10 |
| 1992734743 | Baker Clinic, LLP | Clinic/Center | 3175 Pocahontas Rd, Baker City, OR 97814-1434 | 2006-07-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083279871 | Charles Henry Campos | Counselor | 2021 Court Street, Baker City, OR 97814 | 2019-05-07 |
| 1831546217 | Veronica Crowder | Physician Assistant | Samg Orthopedics Baker City, 3325 Pocahontas Rd, Baker City, OR 97814 | 2016-05-16 |
| 1013389956 | Dara Michelle Fields | Counselor | 2200 4th Street, Baker City, OR 97814 | 2015-10-29 |
| 1003223694 | Colleen Davenport | Nurse Practitioner | 3975 N Midway Dr, Baker City, OR 97814 | 2014-07-16 |
| 1629418363 | Sherry Melena Zacharias Forsyth | Counselor | 2100 Main St., New Directions, Baker City, OR 97814 | 2013-06-26 |
| 1609215573 | Logan Clay Frederickson | Family Medicine | 3820 17th Street, Baker City, OR 97814 | 2013-06-24 |
| 1790124485 | James Lee Morris | Counselor | 3610 Midway, Baker City, OR 97814 | 2013-06-17 |
| 1881955656 | New Directions Northwest, Inc | Substance Abuse Rehabilitation Facility | 3610 Midway Drive, Baker City, OR 97814 | 2012-06-07 |
| 1972864759 | New Directions Northwest, Inc. | Substance Abuse Rehabilitation Facility | 3700 Midway Drive, Baker City, OR 97814 | 2012-06-07 |
| 1659671113 | Al H Brickman | Pharmacist | 1205 Campbell St., Baker City, OR 97814 | 2010-10-29 |
| Find all providers in zip 97814 | ||||
| Taxonomy Code | 207RR0500X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Rheumatology |
| An internist who treats diseases of joints, muscle, bones and tendons. This specialist diagnoses and treats arthritis, back pain, muscle strains, common athletic injuries and "collagen" diseases. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528295557 | Ajay Wanchu | Internal Medicine | 10101 Se Main St Ste 2011, Portland, OR 97216-2457 | 2009-06-17 |
| 1023229812 | Sarah Jan Lipton | Internal Medicine | 5050 Ne Hoyt St Ste 155, Portland, OR 97213-2956 | 2007-05-24 |
| 1871706218 | Shawn Gonda Macalester | Internal Medicine | 545 Se Oak St Ste F, Hillsboro, OR 97123-4147 | 2007-05-08 |
| 1053442855 | Arthritis and Osteoporsis Clinic LLC | Internal Medicine | 2200 Ne Neff Rd Ste 302, Bend, OR 97701-4279 | 2007-03-07 |
| 1316035728 | Drs Cassell & Boren PC | Internal Medicine | 132 E Broadway Suite 830, Drs Cassell & Boren PC, Eugene, OR 97401-3160 | 2006-10-11 |
| 1215035449 | Mollie E Thompson | Internal Medicine | 9155 Sw Barnes Rd Ste 314, Portland, OR 97225-6630 | 2006-09-20 |
| 1417068198 | Ann Marie Macasa | Internal Medicine | 402 Villa Rd, Newberg, OR 97132-1831 | 2006-08-31 |
| 1912019217 | Michelle Marie Ryan | Internal Medicine | 3620 Nw Samaritan Dr Ste 202, Corvallis, OR 97330-3785 | 2006-08-31 |
| 1093724247 | Sarah Cassell | Internal Medicine | 132 E Broadway Ste 830, Eugene, OR 97401-3181 | 2006-08-05 |
| 1639114358 | Raymond Charles Hausch | Internal Medicine | 960 Liberty St Se Ste 200, Salem, OR 97302-4195 | 2006-06-17 |
| Find all providers with the same taxonomy | ||||
| City | BAKER CITY |
| Zip Code | 97814 |
Please comment or provide details below to improve the information on DR. LESLIE W JACKSON.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.