Kyle L Jackson
Medical Specialty
Professional ID
- NPI: 1861597908
- PECOS ID: 4385818772
- Enrollment ID: I20111121000821
- Credential(MD, DO, DPM):
- Medical School:
- Medical School Graduation Year: 2001
Medical Practices
- Organization Name: Sport And Spine Therapy Of Marin Inc
- Group Practice ID assigned by PECOS: 4981617180
- Number of Group Practice member: 12
Location
- Address1: 719 Southpoint Blvd
- Address2: Suite A
- City: Petaluma
- State: California
- Zip Code: 94954
- Phone Number: (707)981-8062
Location
- Address1: 88 Rowland Way
- Address2: Suite 250
- City: Novato
- State: California
- Zip Code: 94945
- Phone Number: (415)898-1311
Medicare
- Medicare Assignment: Yes
- Report Quality of Care to Physician Quality Reporting System (PQRS): Yes
- Used Electronic health record (EHR):