Jackson Medical Clinic, PC
NPI 1457594699 · General Practice Physician · Wagoner, OK
Jackson Medical Clinic, PC is a General Practice Physician organization in Wagoner, OK (NPI 1457594699).
Provider details
- NPI number
- 1457594699
- Entity type
- Organization
- Primary specialty
- General Practice PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Kelly Haley, Office Manager(918) 485-5591
- License
- 28153 (OK)
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
17 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
Mailing address
Other names (DBA / former)
- Former legal business name
- Jackson Family Clinic
Registry dates
- Enumerated
- 2009-04-17
- Last updated
- 2017-03-22
Frequently asked questions
- What is Jackson Medical Clinic, PC's NPI number?
- Jackson Medical Clinic, PC's National Provider Identifier (NPI) is 1457594699, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Jackson Medical Clinic, PC?
- Jackson Medical Clinic, PC is classified in the NPPES registry as General Practice Physician (Allopathic & Osteopathic Physicians).
- Where is Jackson Medical Clinic, PC located?
- Jackson Medical Clinic, PC's practice location on file with NPPES is 410 E Cherokee St, Wagoner, OK 74467-4708.
- What is Jackson Medical Clinic, PC's phone number?
- The practice phone number listed in the NPPES registry for Jackson Medical Clinic, PC is (918) 485-5591.
- Who is the authorized official for Jackson Medical Clinic, PC?
- The authorized official listed on Jackson Medical Clinic, PC's NPPES record is Kelly Haley, Office Manager. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Jackson Medical Clinic, PC's NPI active?
- Yes — Jackson Medical Clinic, PC's NPI (1457594699) is active in the NPPES registry as of the last update on 2017-03-22.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.