IndividualActive
Chad Jackson, MS, ATC
NPI 1518484245 · Sports Medicine (Preventive Medicine) Physician · Fort Myers, FL
Provider details
- NPI number
- 1518484245
- Entity type
- Individual
- Primary specialty
- Sports Medicine (Preventive Medicine) PhysicianAllopathic & Osteopathic Physicians
- Credential
- MS, ATC
- Sex
- Male
- Sole proprietor
- Yes
- License
- AL2986 (FL)
Practice location
14110 Six Mile Cypress Pkwy
Fort Myers, FL 33912-4314
Phone: (239) 479-6411
Fax: (239) 768-2032
Mailing address
618 Se 3rd St
Cape Coral, FL 33990-1109
Registry dates
- Enumerated
- 2017-08-24
- Last updated
- 2017-08-24
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.