Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Dr. Mark R. Jackson, MD

Individual provider Emergency Medical Services (Emergency Medicine) Physician · NPI 1003877077

Dr. Mark R. Jackson, MD is an Emergency Medicine in Tooele, Utah. Qualified in 1995, 31 years ago. Practices with Fedko Emergency Physicians New Mexico, LLC, a 51-clinician group and accepts Medicare assignment. Licensed in Utah.

Years since qualifying
31
Licensed in
UT
In the registry since
2006
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

1474 E Erda Way
Tooele, UT 84074-9737
Phone: (435) 849-0779
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Emergency Medical Services (Emergency Medicine) Physician (primary) Taxonomy 207PE0004X · Licence 5929640-1205 (UT)

Record details

NPI number1003877077
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedMarch 30, 2006
Last updated in NPPESMarch 21, 2016

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyEMERGENCY MEDICINE
Medical schoolOTHER
Graduated 1995 (31 years in practice)
Group practice Fedko Emergency Physicians New Mexico, Llc — 51 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations5 on file with Medicare

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