DR. CHARLES EDWARD JACOCKS (NPI# 1104321967) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1104321967 |
| Entity Type | Individual |
| Full Name | DR. CHARLES EDWARD JACOCKS |
| Credential | MD |
| Practice Address |
301 Fisher St Biloxi MS 39534-2508 |
| Practice Telephone | 2283720577 |
| Practice Fax Number | 9082823289 |
| Mailing Telephone | 8039835013 |
| Mailing Fax Number | 9082823289 |
| Enumeration Date | 2018-03-26 |
| Last Update Date | 2018-09-26 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207R00000X | Internal Medicine | T-3584 | MS | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720051105 | Charles West Jacocks Iv | Internal Medicine | 2300 Ramsey St Rm 304-a, Fayetteville, NC 28301-3856 | 2006-02-08 |
| Street Address |
301 FISHER ST |
| City | BILOXI |
| State | MS |
| Zip Code | 39534-2508 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861099913 | Enrique I Padron | Military Health Care Provider | 301 Fisher St, Biloxi, MS 39534-2508 | 2020-10-01 |
| 1891307096 | Allison Kathleen Rita Hauge | Student in an Organized Health Care Education/Training Program | 301 Fisher St, Biloxi, MS 39534-2508 | 2020-08-19 |
| 1417569625 | Ryan Woolfe | Student in an Organized Health Care Education/Training Program | 301 Fisher St, Biloxi, MS 39534-2508 | 2020-08-19 |
| 1457963027 | Crystal Lee Cowan | Student in an Organized Health Care Education/Training Program | 301 Fisher St, Biloxi, MS 39534-2508 | 2020-08-17 |
| 1811505910 | Michael Andes | Dentist | 301 Fisher St, Biloxi, MS 39534-2508 | 2020-07-15 |
| 1275155301 | Emily Kathryn Doe | Student in an Organized Health Care Education/Training Program | 301 Fisher St, Biloxi, MS 39534-2508 | 2020-05-12 |
| 1578185955 | Sean Lan | Student in an Organized Health Care Education/Training Program | 301 Fisher St, Biloxi, MS 39534-2508 | 2020-05-08 |
| 1427679109 | Nicholas William D'amico | Student in an Organized Health Care Education/Training Program | 301 Fisher St, Biloxi, MS 39534-2508 | 2020-05-04 |
| 1487283701 | Jeremy Alan Meldrum | Student in an Organized Health Care Education/Training Program | 301 Fisher St, Biloxi, MS 39534-2508 | 2020-04-07 |
| 1881229623 | Jesse Recarte | Military Health Care Provider | 301 Fisher St, Biloxi, MS 39534-2508 | 2020-03-11 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316568918 | Hanna Chang | Student in an Organized Health Care Education/Training Program | 81 Msgs/gme (keesler Afb), 301 Fisher St, Rm 5a127, Biloxi, MS 39534 | 2020-05-05 |
| 1720617079 | Briana Polk | Student in an Organized Health Care Education/Training Program | Keesler Air Force Base, 301 Fisher Street, Biloxi, MS 39534 | 2020-04-07 |
| 1437718756 | Marquise Westbrook | Student in an Organized Health Care Education/Training Program | 301 Fisher St, Rm 1g123, Keesler Afb, MS 39534 | 2019-06-11 |
| 1124682729 | Joseph Paul Cervone | Student in an Organized Health Care Education/Training Program | 81 Mdss/gme 301 Fisher St, Rm 1g123, Keesler Afb, MS 39534 | 2019-04-29 |
| 1083120851 | Kaitlin May Gruenberg | Student in an Organized Health Care Education/Training Program | 81 Msgs/gme, 301 Fisher St, Rm 5a127, Keesler Afb, MS 39534 | 2017-12-15 |
| 1760912513 | Michael Zipper | Military Health Care Provider | 301 Fisher St, Rm 5a127, 81msgs/sgcq, Keesler Afb, MS 39534 | 2017-06-14 |
| 1184073181 | 81msgs/sgcq | General Acute Care Hospital | 81msgs/sgcq, 301 Fisher St, Rm 5a127, Keesler Afb, MS 39534 | 2016-06-09 |
| 1174972772 | Usaf 81st Medical Group | Military Hospital | 81msgs/sgcq 301 Fisher St, Rm 5a127, Keesler Afb, MS 39534 | 2016-06-06 |
| 1548644677 | Jim Li | Dentist | 81st Medical Group, Keesler Afb, Apo, AA 39534 | 2015-07-18 |
| 1245610872 | Zachary Austin Masters | Surgery | 301 Fisher Street, Rm 5a127, Keesler Air Force Base, MS 39534 | 2015-06-09 |
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| Taxonomy Code | 207R00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609203173 | Memorial Hospital At Gulfport | Internal Medicine | 1756 Popps Ferry Rd Ste A, Biloxi, MS 39532-2118 | 2013-09-30 |
| 1285845933 | Azad Alamgir Kabir | Internal Medicine | 1120 Beach Blvd, Biloxi, MS 39530-3631 | 2007-05-24 |
| 1770705204 | Syeda Shaista Rumman | Internal Medicine | 400 Veterans Ave Bldg 3, Room 126d, Biloxi, MS 39531-2410 | 2007-05-03 |
| 1942367164 | Rachael F Tadlock | Internal Medicine | 1721 Medical Park Dr Ste 101, Biloxi, MS 39532-2105 | 2007-01-03 |
| 1346322880 | Tricia K Aultman | Internal Medicine | 1009 Tommy Munro Dr, Biloxi, MS 39532-2100 | 2006-10-20 |
| 1891729190 | Hammed Kehinde Olarinde | Internal Medicine | Va Gulf Coast Vets Hcs, 400 Veterans Avenue, Biloxi, MS 39531 | 2006-07-10 |
| 1164450359 | Gulf Coast Internal Medicine Pllc | Internal Medicine | 1721 Medical Park Dr, Ste 101, Biloxi, MS 39532 | 2006-06-28 |
| 1083661946 | Belinda Alexander | Internal Medicine | 2771 Pass Rd, Suite A, Biloxi, MS 39531-2600 | 2006-05-27 |
| 1558323964 | Dawn Mae Hansen | Internal Medicine | 2550 Pass Rd, Biloxi, MS 39531-2726 | 2006-04-03 |
| 1306826854 | Andrew J. Peterson | Internal Medicine | 147 Reynoir Street, Suite 101, Biloxi, MS 39530 | 2006-01-20 |
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| 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.