IndividualActive
Jackson Law, DPM
NPI 1114507795 · Foot & Ankle Surgery Podiatrist · Enterprise, OR
Provider details
- NPI number
- 1114507795
- Entity type
- Individual
- Primary specialty
- Foot & Ankle Surgery PodiatristPodiatric Medicine & Surgery Service Providers
- Credential
- DPM
- Sex
- Male
- Sole proprietor
- Yes
- License
- 221041 (OR)
Specialties & taxonomies
Podiatric Medicine & Surgery Service Providers
Practice location
601 Medical Pkwy
Enterprise, OR 97828-5124
Phone: (541) 426-3111
Approximate (ZIP-level) locationGet directions
Mailing address
911 Hamel Dr
Enterprise, OR 97828-1437
Registry dates
- Enumerated
- 2021-04-08
- Last updated
- 2024-11-05
- Certified
- 2024-11-05
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.