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

Matthew R Jackson, DO

Individual provider Family Medicine Physician · NPI 1588897896

Matthew R Jackson, DO is a Family Practice in Traverse City, Michigan. Qualified in 2005, 21 years ago. Practices with Crystal Lake Clinic PC, a 13-clinician group, accepts Medicare assignment and offers telehealth. Licensed in Michigan and Ohio.

Years since qualifying
21
Licensed in
MI, OH
In the registry since
2009
Specialties on file
3
What do these letters mean?
DO — Doctor of Osteopathic Medicine
A fully licensed physician, trained like an MD with additional musculoskeletal training. Equivalent practice rights in all 50 states.

See every abbreviation used in this directory →

Practice location Address checks out

1225 W Frnt ST
Traverse City, MI 49684-2368
Phone: (231) 935-0788
Fax: (231) 935-0787
Show map & directions

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

Specialties & licences

Sports Medicine (Family Medicine) Physician (primary) Taxonomy 207QS0010X · Licence 5101018472 (MI)
Family Medicine Physician Taxonomy 207Q00000X · Licence 5101018472 (MI)
Sports Medicine (Family Medicine) Physician Taxonomy 207QS0010X · Licence 34.010954 (OH)

Record details

NPI number1588897896
Entity typeIndividual (Type 1)
GenderMale
Credentials DO
Sole proprietorNo
NPI enumeratedSeptember 2, 2009
Last updated in NPPESDecember 21, 2020
Certification dateDecember 21, 2020
Mailing address1225 W Front St, Traverse City, MI 49684-2368

Medicare enrollment

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

Medicare specialtyFAMILY PRACTICE
Medical schoolOTHER
Graduated 2005 (21 years in practice)
Group practice Crystal Lake Clinic Pc — 13 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services
Practice locations2 on file with Medicare

Other providers in Traverse City