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

Thomas V Jackson, MD

Individual provider Emergency Medicine Physician · NPI 1700862992

Thomas V Jackson, MD is an Emergency Medicine Physician in Portage, Wisconsin. Licensed in Wisconsin. Registered with an NPI since 2005.

Licensed in
WI
In the registry since
2005
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

2817 New Pinery Rd Divine Savior Healthcare Inc
Portage, WI 53901-9257
Phone: (608) 742-4131
Fax: (608) 745-5173
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Emergency Medicine Physician (primary) Taxonomy 207P00000X · Licence 21269020 (WI)

Record details

NPI number1700862992
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedDecember 20, 2005
Last updated in NPPESJanuary 30, 2012

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