IndividualActive
Mark Jackson, M.D.
NPI 1255470209 · Addiction Medicine (Anesthesiology) Physician · Saint Augustine, FL
Provider details
- NPI number
- 1255470209
- Entity type
- Individual
- Primary specialty
- Addiction Medicine (Anesthesiology) PhysicianAllopathic & Osteopathic Physicians
- Credential
- M.D.
- Sex
- Male
- Sole proprietor
- No
- License
- 40009 (KY)
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Allopathic & Osteopathic Physicians
Allopathic & Osteopathic Physicians
Practice location
3930 US 1 S
Saint Augustine, FL 32086-7089
Phone: (352) 283-3568
Fax: (904) 217-3081
Approximate (ZIP-level) locationGet directions
Mailing address
4881 Nw 8th Ave
Gainesville, FL 32605-4582
Registry dates
- Enumerated
- 2007-02-06
- Last updated
- 2020-08-17
- Certified
- 2020-08-17
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.