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

Jackson Medical Clinic, PC

Organization General Practice Physician · NPI 1457594699

Jackson Medical Clinic, PC is a General Practice Physician in Wagoner, Oklahoma. Licensed in Oklahoma. Registered with an NPI since 2009.

Licensed in
OK
In the registry since
2009
What do these letters mean?
PC — Professional corporation
A form of business registration, not a clinical qualification.

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Practice location Address checks out

410 E Cherokee St
Wagoner, OK 74467-4708
Phone: (918) 485-5591
Fax: (918) 485-5758
Show map & directions

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

Specialties & licences

General Practice Physician (primary) Taxonomy 208D00000X · Licence 28153 (OK)

Record details

NPI number1457594699
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Kelly Haley — Office Manager · (918) 485-5591
Other names Jackson Family Clinic
NPI enumeratedApril 17, 2009
Last updated in NPPESMarch 22, 2017
Mailing address410 E Cherokee St, Wagoner, OK 74467-4708

Other providers in Wagoner