DR. TIMOTHY D JACKSON


Address: 12080 New Orleans Ave N, Gulfport, MS 39503-3180
Phone: 2288329933

DR. TIMOTHY D JACKSON (NPI# 1093710089) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1093710089
Entity Type Individual
Full Name DR. TIMOTHY D JACKSON
Credential M.D.
Practice Address 12080 New Orleans Ave N
Gulfport
MS 39503-3180
Mailing Address Po Box 10049
Gulfport
MS 39505-0049
Practice Telephone 2288329933
Practice Fax Number 2288329916
Mailing Telephone 2288329933
Mailing Fax Number 2288329916
Enumeration Date 2005-06-16
Last Update Date 2010-07-09
Gender Code M
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 207X00000X Orthopaedic Surgery 14510 MS Allopathic & Osteopathic Physicians

Other Provider Identifier

State Issuer Identifier Type Code
MS 00124986 05
MS 9015866 05

Other Providers TIMOTHY JACKSON

NPI Name Taxonomy Address Enumeration
1124338504 Timothy Lawrence Jackson Physician Assistant 2722 N Mariah Way, Flagstaff, AZ 86004-7550 2010-10-19
1972610947 Timothy Michael Jackson Dentist 982 Drayton Avenue, Elba, AL 36323 2006-08-24
1255444766 Timothy K Jackson Internal Medicine 710 Genesis Blvd, Bridgeport, WV 26330-9668 2006-08-17
1982623625 Timothy L Jackson Physician Assistant 5249 Providence Rd, Virginia Beach, VA 23464-4201 2006-07-19
1710473368 Timothy Jackson Registered Nurse 1644 Central Ave, Mckinleyville, CA 95519-4342 2018-07-06
1336634641 Timothy Jackson Social Worker 3820 Nine Mile Rd, Richmond, VA 23223-4831 2018-06-28
1538512520 Timothy Jackson Physical Therapist 97 Gateway Business Park Dr, Ringgold, GA 30736-7395 2016-07-14
1538485396 Timothy William Jackson Counselor 115 Liberty St, Bath, NY 14810-1508 2010-04-19
1598997751 Timothy William Jackson Physical Therapist 8918 Blakeney Professional Dr, Suite 120, Charlotte, NC 28277-6691 2009-08-20
1679704001 Timothy D Jackson Surgery Massachusetts General Hospital, 55 Fruit St., Boston, MA 02114 2009-08-03

Office Location

Street Address 12080 NEW ORLEANS AVE N
City GULFPORT
State MS
Zip Code 39503-3180

Providers in the same location

NPI Name Taxonomy Address Enumeration
1003958117 Moriah Specialist 12080 New Orleans Ave N, Gulfport, MS 39503-3180 2007-02-13

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1013515451 Gulf Coast Neurospa, LLC Psychiatry & Neurology 8845 Lorraine Road, Gulfport, MS 39503 2020-10-16
1447865985 Nicholas Wyrosdick Physical Therapist 12261 Us 49 #1, Gulfport, MS 39503 2020-09-11
1750935169 Ladner Roy Drugs, LLC. Pharmacy 12261 Us 49 Suite 16, Gulfport, MS 39503 2019-07-25
1528559440 Alexander Therapy Services, LLC Clinic/Center 15465 Oak Ln Ste 100c, Gulfport, MS 39503 2018-05-25
1750879003 Heather Lynn Theisen Nurse Practitioner 15190 Community Rd Ste 330, Gulfport, MS 39503 2018-04-23
1083101216 Gulf Coast Mental Health Center Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities 15094 County Barn Road, Gulfport, MS 39503 2018-04-13
1306343173 Dr. Raymond Monsour Scurfield, LLC Community/Behavioral Health 15465 Oak Lane Ste 100-g, Gulfport, MS 39503 2018-04-09
1952817157 Mary Beth Welch Behavioral Analyst 9230 Old Lorraine Rd, Gulfport, MS 39503 2017-12-26
1831603257 Beach View Family Dental, Pllc Dentist 9072 Lorraine Road, Gulfport, MS 39503 2017-11-21
1437677721 Mary Stephens Ruffin Social Worker 11262 Creek Dr, Gulfport, MS 39503 2017-09-07
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Taxonomy Information

Taxonomy Code 207X00000X
Grouping Allopathic & Osteopathic Physicians
Classification Orthopaedic Surgery

Taxonomy Definition

An orthopaedic surgeon is trained in the preservation, investigation and restoration of the form and function of the extremities, spine and associated structures by medical, surgical and physical means. An orthopaedic surgeon is involved with the care of patients whose musculoskeletal problems include congenital deformities, trauma, infections, tumors, metabolic disturbances of the musculoskeletal system, deformities, injuries and degenerative diseases of the spine, hands, feet, knee, hip, shoulder and elbow in children and adults. An orthopaedic surgeon is also concerned with primary and secondary muscular problems and the effects of central or peripheral nervous system lesions of the musculoskeletal system.
Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source]
- Additional Resources: American Board of Orthopaedic Surgery, 2007. http://www.abos.org/. American Osteopathic Board of Orthopaedic Surgery, 2007. http://www.osteopathic.org/certification
- Board certification for Medical Doctors (MDs) is provided by the American Board of Orthopaedic Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Orthopaedic Surgery.

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1093901902 William Lewis Seidensticker Orthopaedic Surgery 2 Bayou Pl, Gulfport, MS 39503-6231 2007-09-25
1306872171 Eric Jude Letonoff Orthopaedic Surgery 452 Courthouse Rd Ste G, Gulfport, MS 39507-1800 2006-06-24
1689673071 James C Thriffiley Iv Orthopaedic Surgery 1639 E Pass Rd, Gulfport, MS 39507 2005-07-18
1003254525 Philip D Myers Orthopaedic Surgery 15190 Community Rd, Gulfport, MS 39503 2013-06-06
1609163682 Joseph Tyler Cox Orthopaedic Surgery 15476 Dedeaux Rd, Gulfport, MS 39503 2011-06-29
1750558375 Memorial Hospital At Gulfport Orthopaedic Surgery 1340 Broad Ave, Suite 450 O, Gulfport, MS 39501-2404 2008-05-13
1043408339 Memorial Hospital At Gulfport Orthopaedic Surgery 1340 Broad Ave, Suite 450, Gulfport, MS 39501-2404 2007-10-11
1760531982 Ronald Arly Graham Orthopaedic Surgery 15190 Community Rd, #360, Gulfport, MS 39503-2008 2007-01-09
1588725519 Inez M Kelleher Orthopaedic Surgery 1340 Broad Ave, Ste 450, Gulfport, MS 39503 2006-12-13

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1619526852 Msk Group, PC Orthopaedic Surgery 7900 Airways Blvd Bldg B102, Southaven, MS 38671-4118 2019-09-10
1790193050 Och Orthopedic Center Orthopaedic Surgery 401 Hospital Rd, Starkville, MS 39759-2164 2014-07-30
1679909774 Irvin L. Martin IIi Md Pllc Orthopaedic Surgery 1800 12th St Ste 1e, Meridian, MS 39301-4158 2013-09-20
1073946216 Madison Physician Surgery Center, LLC Orthopaedic Surgery 4510 Lakeland Dr, Flowood, MS 39232-9583 2013-08-12
1386076743 William Ladwick Hand Orthopaedic Surgery 304 Kings Common, Ridgeland, MS 39157 2013-08-07
1184068413 Thomas Payne Royals Orthopaedic Surgery 103 Tatum Rd, Hattiesburg, MS 39401-5186 2013-04-17
1639426117 Southern Bone & Joint Specialists, Pa Orthopaedic Surgery 7127 Highway 98, Suite 20, Hattiesburg, MS 39402 2012-08-14
1487901807 Southern Bone & Joint Specialists, Pa Orthopaedic Surgery 1215 Highway 98 Byp, Columbia, MS 39429-3702 2012-08-06
1477817799 Matthew A Miller Orthopaedic Surgery 1211 South Gloster St, Suite A, Tupelo, MS 38801 2012-07-02
1831453158 Phillip Anthony Sandifer Orthopaedic Surgery 100 Baptist Memorial Cir Ste 330, Oxford, MS 38655-4477 2012-07-02
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Competitor

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City GULFPORT
Zip Code 39503

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Dataset Information

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.

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