Healthcare Provider Details

I. General information

NPI: 1265567267
Provider Name (Legal Business Name): DARIN E JACKSON MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/22/2007
Last Update Date: 12/05/2025
Certification Date: 12/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17650 WRIGHT ST STE 3
OMAHA NE
68130-2800
US

IV. Provider business mailing address

1201 RANCH VIEW LN
ELKHORN NE
68022-2239
US

V. Phone/Fax

Practice location:
  • Phone: 402-334-5433
  • Fax: 402-333-1037
Mailing address:
  • Phone: 402-650-7333
  • Fax: 402-333-1037

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number20271
License Number StateNE
# 2
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number20271
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: