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1982654828

NPI Code Detail

MEDICARE: DR. ROBERT FRANKLIN JACKSON II D.O.

MEDICARE: DR. ROBERT FRANKLIN JACKSON II D.O.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207X00000X	Orthopaedic Surgery Physician	02001273A	IN
2	207X00000X	Orthopaedic Surgery Physician	02001273	IN
3	207X00000X	Orthopaedic Surgery Physician	21371	WI
4	207X00000X	Orthopaedic Surgery Physician	76572	WI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	000000082970	OTHER	IN	ANTHEM BCBS
2	02001273	OTHER	IN	LICENSE
3	0426440001	OTHER	IN	DME
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1982654828
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ROBERT FRANKLIN JACKSON II D.O.

Provider Business Mailing Address
First Line	:	PO BOX 670
Second Line	:
City	:	HUNTERTOWN
State	:	IN
Zip	:	46748-0670
Country	:	US
Telephone Number	:	260-748-3650
Fax Number	:	260-748-3651

Provider Business Practice Location Address
First Line	:	1721 MAGNAVOX WAY
Second Line	:
City	:	FORT WAYNE
State	:	IN
Zip	:	46804-1537
Country	:	US
Telephone Number	:	260-748-3650
Fax Number	:	260-748-3651

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/11/2006
Last Update Date	:	01/30/2026

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Directions to “ DR. ROBERT FRANKLIN JACKSON II D.O.” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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