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

Jackson Rodgers, PHYSICIANASSISTANT

Individual provider Physician Assistant · NPI 1760005664

Jackson Rodgers, PHYSICIANASSISTANT is a Physician Assistant in Oklahoma City, Oklahoma. Practices as a sole proprietor and works from 2 locations. Licensed in Oklahoma.

Licensed in
OK
In the registry since
2020
Specialties on file
3

Practice location Address checks out

1000 N Lee Ave
Oklahoma City, OK 73102-1036
Phone: (405) 272-7000
Show map & directions

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

Additional practice locations (1)

  • 5a Whispering Pines Ct, Macon, IL 62544-7218 — (636) 866-8958

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 4644 (OK)
Physician Assistant Taxonomy 363A00000X
Student in an Organized Health Care Education/Training Program Taxonomy 390200000X

Record details

NPI number1760005664
Entity typeIndividual (Type 1)
GenderMale
Credentials PHYSICIANASSISTANT
Sole proprietorYes
NPI enumeratedMay 26, 2020
Last updated in NPPESJune 9, 2022
Certification dateJune 9, 2022

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