Dr. Edgar Basil Jackson
MD | Psychiatry | Addiction Medicine | 68+ years Exp
1225 W Mitchell St, 223, Milwaukee
Wisconsin, 53204-3383
414-383-4455 414-727-8730
Maps & DirectionsDr. Edgar Basil Jackson is a Milwaukee, Wisconsin based psychiatrist with 68 years of experience in Addiction Medicine. He completed his graduation in 1957. He accepts the Medicare-approved amount. Patients will not be billed for any more than the Medicare deductible and coinsurance. Active license number of Dr. Edgar Basil Jackson is 13939-20 for Psychiatry in Wisconsin. His current practice location is 1225 W Mitchell St, 223, Milwaukee. Patients can reach him at 414-383-4455 or can fax him at 414-727-8730. Dr. Edgar Basil Jackson is MD in Addiction Medicine and his NPI number (Unique professional ID assigned by NPPES) is 1598833410.
Dr. Edgar Basil Jackson focuses on the evaluation, diagnosis, and treatment of people who have one or more disorders related to addictions like illegal drugs, alcohol, and prescription medication and other substances.
Complete Profile:
Dr. Edgar Basil Jackson speciality, credentials, practice address, contact phone number and fax are as below.
Patients can call on the below given phone number for appointment.
| Name: | Dr. Edgar Basil Jackson |
| Specialization: | Addiction Medicine |
| Gender: | Male |
| Credentials: | MD |
| Experience: | 68+ years |
| Medical School Attended: | Other |
| Graduation Year: | 1957 |
| Accepts Medicare Assignment: | Yes |
| Practice Address: | 1225 W Mitchell St, 223, Milwaukee,
Wisconsin, 53204-3383 |
| Phone: | 414-383-4455 |
| Fax: | 414-727-8730 |
Professional Identification Codes:
NPI number stands for National Provider Identifier which is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS).
NPI details are as mentioned below.
| PAC ID: | 6103879697 |
| Enrollment ID: | I20050224000385 |
| NPI Number: | 1598833410 |
| NPI Enumeration Date: | 30 Nov, 2006 |
| NPI Last Update On: | 03 Jul, 2024 |
Medical Licenses:
Doctors can have one or more medical licenses for different specialities in the same state or different states. Related medical licenses for Dr. Edgar Basil Jackson are as mentioned below.
| License Number | Specialization | State | Status | |
| 13939-20 | Psychiatry | Wisconsin | Primary | |
| AJ8930984 XJ8930984 | Addiction Medicine | Wisconsin | Secondary | |
Group Practice:
Group practices are practice of medicine by a group of physicians who share their premises and other resources. Following list states all the group name
with which Dr. Edgar Basil Jackson is associated with along with the number of members in that group.
| Organization Name (Group PAC ID) | Members |
| Milwaukee Health Services, Inc. (7416946884) | 26 |
Other Medical Identifiers:
Other legacy medical identifiers associated with Dr. Edgar Basil Jackson such as Medicaid, Medicare PIN, NSC, UPIN etc. are mentioned as below.
| Identifier | Type | State | Issuer |
| 1598833410 | Other | Wisconsin | NPI |
| 30954700 | Medicaid | Wisconsin | |
Business Mailing Address:
Business mailing address can be used for mailing purpose only, for visiting purpose patients need to refer above mentioned address.
| Address: | Dr. Edgar Basil Jackson
1225 W Mitchell St, 223
Milwaukee, Wisconsin |
| Zip: | 53204-3383 |
| Phone Number: | 414-383-4455 |
| Fax Number: | 414-727-8730 |
Patients can reach Dr. Edgar Basil Jackson at
1225 W Mitchell St, 223, Milwaukee, Wisconsin or can
call to book an appointment on 414-383-4455.
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Data of this site is collected from Medicare & Medicaid Services (CMS) and NPPES. Last updated on 08 December, 2025.