NPI age
13 years
Enumerated 2013-04-17
● Active
Type 1 · Individual
DR. Chad Harman Jackson, MD
Jackson is 1 of 36 ophthalmology providers in Boise and 1 of 122 in Idaho.
Primary specialty
Ophthalmology
Plus 2 subspecialties
Licensed in
ID, WI, NV
3 states
Status
Active
No deactivations on record
Last NPPES update
2022-07-21
Source: monthly bulk 2026-05
Sole proprietor
No
May be part of a larger org
How this provider compares
Across 122 active ophthalmology providers in Idaho.
NPI age
13 years
↓ 6 yr below median (19 yr)
State licenses
3 states
Top 87% — 12% of peers are multi-state
Subspecialties
1
In the 27% of peers with subspecialties
NPI lifetime · 2013 → 2026
2013-04Enumerated in NPPES
2013
2026
Where they practice
Practice location
111 W Main St Ste 200
Boise, ID 837027308
Mailing address
111 W Main St Ste 200
Boise, ID 837027308
Additional practice locations
3 secondary locations on file with NPPES.
Location 2
4502 Medical Dr
San Antonio, TX 782294402
Location 3
925 N 87th St
Milwaukee, WI 532264812
Location 4
5435 Reno Corporate Dr Ste 100
Reno, NV 895112250
Specialties
-
Ophthalmology PrimaryAn ophthalmologist has the knowledge and professional skills needed to provide comprehensive eye and vision care. Ophthalmologists are medically trained to diagnose, monitor and medically or surgically treat all ocular and visual...
-
OphthalmologyA physician who specializes in oculofacial plastic and reconstructive surgery. This subspecialty combines orbital and periocular surgery with facial plastic surgery, and includes aesthetic and reconstructive surgery of the face, orbit,...
Identifiers
| Type | Value | Notes |
|---|---|---|
| 05 (WI) | 1184067498 |
Multi-state credentialing: Licensed in 3 states. Useful context for credentialers building cross-state provider networks.
Practice context
Part of a multi-provider practice. 2 other active providers share this practice address in NPPES.
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