Whalio Doctors

NPI 1184740045

Robert Elvon Jackson, MD

Practitioner Urology Physician Meridian, ID

Practice location

Address
875 S Vanguard Way Suite 200 D, Meridian, ID 83642
Phone
(208) 782-6730
Fax
(208) 759-7822

Registered specialties (3)

Urology Physician Primary
Allopathic & Osteopathic Physicians Taxonomy 208800000X Licence M-11868 (ID)
Student in an Organized Health Care Education/Training Program
Student, Health Care Taxonomy 390200000X Licence 4301087650 (MI)
Urology Physician
Allopathic & Osteopathic Physicians Taxonomy 208800000X Licence 4301087650 (MI)

Registry record

NPI
1184740045
Entity type
Individual
Sex (as registered)
Male
NPI issued
22 Mar 2007
Record last updated
2 Jun 2026

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.