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NPI Code Detail

MEDICARE: JOSEPH G JACKO MD

MEDICARE: JOSEPH G JACKO MD
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
1207R00000XInternal Medicine Physician35.055488OH
2207RS0010XSports Medicine (Internal Medicine) Physician35.055488OH

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1730185844
Entity Type Code : Individual
Provider Name (Legal Business Name) : JOSEPH G JACKO MD
Provider Business Mailing Address
First Line : 4885 OLENTANGY RIVER RD
Second Line : SUITE 2-50
City : COLUMBUS
State : OH
Zip : 43214-1952
Country : US
Telephone Number : 614-451-1551
Fax Number : 614-451-2326
Provider Business Practice Location Address
First Line : 4885 OLENTANGY RIVER RD
Second Line : SUITE 2-50
City : COLUMBUS
State : OH
Zip : 43214-1952
Country : US
Telephone Number : 614-451-1551
Fax Number : 614-451-2326
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/23/2005
Last Update Date : 07/30/2013

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