Timothy D Jackson M.D.

NPI 1093710089 - Orthopaedic Surgery - 207X00000X

NPI Details
NPI 1093710089
Gender Male
Enumeration Date 06/16/2005
Last Updated 07/09/2010
Entity Type Individual
Active Over 11 years ago
Practice Location
12080 NEW ORLEANS AVE N
GULFPORT MS, 39503-3180, US
Phone (228) 832-9933
Fax (228) 832-9916
Business Location
PO BOX 10049
GULFPORT MS, 39505-0049, US
Phone (228) 832-9933
Fax (228) 832-9916
Toxanomy
Taxonomy Code 207X00000X
License State Mississippi
License Number 14510
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According to our database, Dr. Timothy D Jackson M.D. NPI is 1093710089, taxonomy code is 207X00000X and license number is 14510, license state is located at Mississippi. Timothy D Jackson M.D. physically located at 12080 New Orleans Ave N, Gulfport MS, 39503-3180. NPI Number Timothy D Jackson M.D. has the Individual type.

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1093710089 NPI number is provided on an as is basis without warranty of any kind. 1093710089 is maintained by the National Plan & Provider Enumeration System. The contents of Timothy D Jackson M.D. are for informational purposes only.