DR. MARK R JACKSON (NPI# 1033177530) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1033177530 |
| Entity Type | Individual |
| Full Name | DR. MARK R JACKSON |
| Credential | MD |
| Practice Address |
3 Saint Francis Dr Suite 330 Greenville SC 29601-3971 |
| Practice Telephone | 8642551834 |
| Practice Fax Number | 8642551836 |
| Mailing Telephone | 8642551834 |
| Mailing Fax Number | 8642551836 |
| Enumeration Date | 2006-05-03 |
| Last Update Date | 2020-11-06 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 2085R0202X |
Radiology Specialization: Diagnostic Radiology |
23559 | SC | Allopathic & Osteopathic Physicians |
| Y | 2086S0129X |
Surgery Specialization: Vascular Surgery |
23559 | SC | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| SC | T78966 | 05 | |
| NC | 89067KH | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 2728 Sunset Blvd Ste 400, West Columbia, SC 291694839 | 8039367095 | 8039367908 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134755721 | Mark Wayne Jackson | Occupational Therapist | 8608 Marys Creek Dr, Benbrook, TX 76116-7624 | 2020-03-16 |
| 1811409535 | Mark Jackson | Driver | 26048 Pine Tree Rd, Rhoadesville, VA 22542-8549 | 2017-11-03 |
| 1932488194 | Mark Monroe Jackson | Social Worker | 119 Kona Dr, Galveston, TX 77554-8623 | 2011-08-05 |
| 1477860757 | Mark Allan Jackson | Technician, Other | 322 S Jefferson St, Louisa, KY 41230-1316 | 2010-09-08 |
| 1063620516 | Mark Kent Jackson | Pharmacist | 605 Hwy 31 South, Suite D, Athens, AL 35611 | 2007-05-18 |
| 1528289881 | Mark Jackson | Preventive Medicine | 10 Standing Rock Agency Avenue, Fort Yates, ND 58538 | 2007-05-02 |
| 1255470209 | Mark F Jackson | Anesthesiology | 3930 Us 1 S, Saint Augustine, FL 32086-7089 | 2007-02-06 |
| 1598788796 | Mark K Jackson | Dentist | 7007 Old Sauk Road, Madison, WI 53717 | 2006-07-26 |
| 1003877077 | Mark R. Jackson | Emergency Medicine | 1474 E Erda Way, Tooele, UT 84074-9737 | 2006-03-30 |
| 1073585238 | Mark A Jackson | Family Medicine | 1000 Pavilions Circle, Mark A Jackson Md Plc, Traverse City, MI 49684 | 2006-02-02 |
| Street Address |
3 SAINT FRANCIS DR SUITE 330 |
| City | GREENVILLE |
| State | SC |
| Zip Code | 29601-3971 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396747929 | Regency Hospital of Greenville, LLC | Long Term Care Hospital | 3 Saint Francis Dr, Suite 440, Greenville, SC 29601-3971 | 2005-08-12 |
| 1609498849 | Stacey Wilson | Nurse Practitioner | 3 Saint Francis Dr, Greenville, SC 29601-3971 | 2020-05-11 |
| 1992278394 | Jessica Lea Rice | Nurse Practitioner | 3 Saint Francis Dr, Greenville, SC 29601-3971 | 2019-01-08 |
| 1942758594 | Jennifer Lyles Standard | Nurse Practitioner | 3 Saint Francis Dr, Suite 330, Greenville, SC 29601-3971 | 2016-09-12 |
| 1275907602 | Hilary Keithe Joseph | Nurse Practitioner | 3 Saint Francis Dr, Suite 360, Greenville, SC 29601-3971 | 2015-11-23 |
| 1295159705 | Piedmont Comprehensive Pain Management Group LLC | Pain Medicine | 3 Saint Francis Dr, Suite 480, Greenville, SC 29601-3971 | 2014-02-05 |
| 1881951499 | Sarah Anne Hensley | Anesthesiology | 3 Saint Francis Dr, Greenville, SC 29601-3971 | 2012-04-19 |
| 1386920593 | John S. Minasi | Surgery | 3 Saint Francis Dr, St 360, Greenville, SC 29601-3971 | 2011-11-01 |
| 1447572169 | Long Huynh-duc | Internal Medicine | 3 Saint Francis Dr, Suite 400, Greenville, SC 29601-3971 | 2010-02-22 |
| 1194987743 | Julia Gillespie Payne | Internal Medicine | 3 Saint Francis Dr, Ste 300, Greenville, SC 29601-3971 | 2008-06-25 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700305620 | True Sleep Diagnostics | Clinic/Center | 220 North Main St Ste 500, Pmb 104, Greenville, SC 29601 | 2017-09-12 |
| 1245786813 | Yvette Ombougno | Registered Nurse | 200 University Ridge, Greenville, SC 29601 | 2016-09-01 |
| 1477921823 | Laura Gore Siefert | Registered Nurse | 1 Saint Francis Drive, Greenville, SC 29601 | 2015-09-02 |
| 1821493826 | Sarah Fuller | Counselor | 602 Pettigru St, Greenville, SC 29601 | 2014-11-03 |
| 1689088932 | Chenille Taylor | Nurse Practitioner | 201 N. Main Street, Greenville, SC 29601 | 2014-06-15 |
| 1861827842 | Caritas Counseling Services LLC | Community/Behavioral Health | 111 Hampton Avenue, St Mary's Catholic Church, Greenville, SC 29601 | 2013-09-09 |
| 1568790335 | Lynn A. Victory | Counselor | 710 Pettigru Street, The Cottage, Greenville, SC 29601 | 2009-12-06 |
| 1386971448 | Lisa Speach | Nurse Practitioner | 3 St. Francis Drive, Suite 300, Greenville, SC 29601 | 2009-11-11 |
| 1851528418 | Adam Shawn Riffle | Specialist/Technologist | 175 Patewood Drive, Greenville, SC 29601 | 2009-06-22 |
| 1114178332 | Margaret W. Lee | Psychologist | 412 Pettigru St., Suite C, Greenville, SC 29601 | 2008-10-07 |
| Find all providers in zip 29601 | ||||
| Taxonomy Code | 2086S0129X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Surgery |
| Specialization | Vascular Surgery |
| A surgeon with expertise in the management of surgical disorders of the blood vessels, excluding the intracranial vessels or the heart. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Surgery, 2007. http://www.absurgery.org/. American Osteopathic Board of Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316944705 | William M Bogey Jr. | Surgery | 115 Heart Dr, East Carolina Heart Institute @ Ecu Dept. of Cvs, Greenville, NC 27834-8944 | 2005-06-30 |
| 1336636786 | Vein Center At Allure Medical Spa, Pllc | Surgery | 540 Old Howell Rd, Greenville, SC 29615-1969 | 2018-04-20 |
| 1740657683 | Jackson Hospital and Clinic Inc | Surgery | 44 Medical Arts Ct, Greenville, AL 36037-3869 | 2015-08-26 |
| 1184945842 | St Francis Physician Services Inc | Surgery | 317 Saint Francis Dr Ste 340, Greenville, SC 29601 | 2010-06-17 |
| 1952531386 | Emilia Maria Krol | Surgery | 200 Patewood Dr Ste C300, Greenville, SC 29615-6324 | 2009-07-20 |
| 1730313313 | Joseph Vincent Valentino Blas | Surgery | 200 Patewood Dr, Suite C300, Greenville, SC 29615-3593 | 2009-05-11 |
| 1154587012 | Sagar S Gandhi | Surgery | 200 Patewood Dr, Suite C300, Greenville, SC 29615-3593 | 2008-07-31 |
| 1548440407 | Greenville Surgical, Pllc | Surgery | 1011 W H Smith Blvd, Suite 100, Greenville, NC 27834-3787 | 2007-11-08 |
| 1962609347 | David Terrell Williams | Surgery | 3 Saint Francis Dr, Ste 330, Greenville, SC 29601-3971 | 2007-06-29 |
| 1386757128 | Tod Martin Hanover | Surgery | 200 Patewood Dr, Suite C300, Greenville, SC 29615-3593 | 2006-08-16 |
| Find all providers in GREENVILLE | ||||
| City | GREENVILLE |
| Zip Code | 29601 |
Please comment or provide details below to improve the information on DR. MARK R JACKSON.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.