DR. ANTHONY WADE JACKSON SR. (NPI# 1154477453) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1154477453 |
| Entity Type | Individual |
| Full Name | DR. ANTHONY WADE JACKSON SR. |
| Credential | M.D. |
| Practice Address |
152 Highway 7 S Oxford MS 38655-5392 |
| Practice Telephone | 6624888878 |
| Mailing Telephone | 6624888878 |
| Enumeration Date | 2007-01-27 |
| Last Update Date | 2015-09-09 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2084P0804X |
Psychiatry & Neurology Specialization: Child & Adolescent Psychiatry |
14917 | MS | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689287328 | Anthony Benedict Jackson | Nurse Practitioner | 8 Radford St # 202, Christiansburg, VA 24073-3320 | 2020-08-24 |
| 1558741652 | Anthony Jackson | Case Manager/Care Coordinator | 2000 Nw 1st St, Boynton Beach, FL 33435-2286 | 2015-06-03 |
| 1922410448 | Anthony Jerome Jackson | Counselor | 1826 Chelsea Rd, Elkins Park, PA 19027-1056 | 2014-06-02 |
| 1245307073 | Anthony Jackson | Counselor | 2237 River Plaza Dr, Sacramento, CA 95833-3836 | 2006-11-29 |
| 1396838868 | Anthony Haig Jackson | Psychiatry & Neurology | 31 Woodlawn Avenue, Needham, MA 02492 | 2006-10-02 |
| 1346254596 | Anthony D Jackson | Dentist | 512 E Alexander St, Plant City, FL 33563-7165 | 2006-07-27 |
| 1720024847 | Anthony L Jackson IIi | Emergency Medicine | 2575 E Bidwell St Ste 160, Folsom, CA 95630-6446 | 2006-06-20 |
| 1568077535 | Anthony Jackson | Chore Provider | 332 S Decatur Blvd, Las Vegas, NV 89107-2804 | 2020-09-15 |
| 1487210399 | Anthony Jackson | Counselor | 5080 Florence Rd, Murfreesboro, TN 37129-2922 | 2019-05-15 |
| 1063076925 | Anthony Earle Jackson | Student in an Organized Health Care Education/Training Program | 3901 Rainbow Blvd, Kansas City, KS 66160-8500 | 2019-04-26 |
| Street Address |
152 HIGHWAY 7 S |
| City | OXFORD |
| State | MS |
| Zip Code | 38655-5392 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649374265 | Mary Sue Speck | Counselor | 152 Highway 7 S, Oxford, MS 38655-5392 | 2006-09-12 |
| 1396346565 | Macy Lillian Newcomb | Social Worker | 152 Highway 7 S, Oxford, MS 38655-5392 | 2020-11-04 |
| 1760082580 | Kimberly Eve Spence | Peer Specialist | 152 Highway 7 S, Oxford, MS 38655-5392 | 2020-10-30 |
| 1932707999 | Tanya Evans | Registered Nurse | 152 Highway 7 S, Oxford, MS 38655-5392 | 2020-10-13 |
| 1578179545 | Tiffany Nail | Registered Nurse | 152 Highway 7 S, Oxford, MS 38655-5392 | 2020-09-16 |
| 1255947248 | Macarah Morris | Counselor | 152 Highway 7 S, Oxford, MS 38655-5392 | 2020-09-16 |
| 1073128641 | Adole Natasha Muruako | Counselor | 152 Highway 7 S, Oxford, MS 38655-5392 | 2020-09-10 |
| 1174137673 | Kristen Lindsey Cauley | Social Worker | 152 Highway 7 S, Oxford, MS 38655-5392 | 2020-09-02 |
| 1447863741 | Elizabeth Danielle Cornelius | Counselor | 152 Highway 7 S, Oxford, MS 38655-5392 | 2020-08-26 |
| 1316550759 | Angel Simmons | Counselor | 152 Highway 7 S, Oxford, MS 38655-5392 | 2020-08-25 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619585809 | Oxford Treatment Center, LLC | Substance Abuse Rehabilitation Facility | 616 Commerce Parkway, Oxford, MS 38655 | 2020-07-14 |
| 1760044465 | Lindsay Low Beauchamp | Speech-Language Pathologist | 169 Ms-6 #102, Oxford, MS 38655 | 2019-07-02 |
| 1861058075 | Tomiko D Mackey | Social Worker | 100 Carriage Cove, Oxford, MS 38655 | 2019-05-13 |
| 1174090039 | Derionne Brooks | Specialist/Technologist | 972 Hathorn Road, University, MS 38655 | 2018-10-30 |
| 1497236327 | Providence Companion Care | Nurse's Aide | 317 Heritage Dr Ste 3b, Oxford, MS 38655 | 2018-08-28 |
| 1255817292 | Marcela Caroline Weber | Counselor | 152 Mississippi 7 South, Oxford, MS 38655 | 2018-07-12 |
| 1649775123 | Oxford Outpatient Center, LLC | Clinic/Center | 611 Commerce Pkwy, Oxford, MS 38655 | 2018-03-27 |
| 1073039962 | Sharon Yvette Holloway | Social Worker | 152 Hwy and South, Oxford, Ms 38655, Oxford, MS 38655 | 2017-08-22 |
| 1447774682 | Courtney M Purvis | Physical Therapist | 300 Enterprise Dr Ste B, Oxford, MS 38655 | 2017-07-31 |
| 1649716580 | Taylor Lynn Smith | Counselor | 152 Ms-7, Oxford, MS 38655 | 2017-01-17 |
| Find all providers in zip 38655 | ||||
| Taxonomy Code | 2084P0804X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Psychiatry & Neurology |
| Specialization | Child & Adolescent Psychiatry |
| Child & Adolescent Psychiatry is a subspecialty of psychiatry with additional skills and training in the diagnosis and treatment of developmental, behavioral, emotional, and mental disorders of childhood and adolescence. |
| Notes: Source: The American Board of Psychiatry and Neurology, Inc. www.abpn.com [1/1/2007: new definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033289004 | Stephan Fredrick Baum | Psychiatry & Neurology | 102 Professional Park Ste A, Oxford, NC 27565-2554 | 2006-11-08 |
| 1710089164 | Granville Health System | Psychiatry & Neurology | 102 Professional Park Ste A, Oxford, NC 27565-2554 | 2006-09-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649466954 | Nazmul Talukdar | Psychiatry & Neurology | 110 Patton Ave, Hattiesburg, MS 39401-6155 | 2007-09-20 |
| 1932321742 | Otis Anderson IIi | Psychiatry & Neurology | 5185 Getwell Rd, Southaven, MS 38671-9691 | 2007-05-02 |
| 1770609364 | Gerri L Hill Chance | Psychiatry & Neurology | 206 Robert Mcdaniel Drive, Hazelhurst, MS 39083 | 2007-03-22 |
| 1841337656 | Cynthia Lufkin Undesser | Psychiatry & Neurology | 402 Wesley Ave, Jackson, MS 39202-1000 | 2007-01-31 |
| 1932290392 | Millcreek Epsdt | Psychiatry & Neurology | 900 First Ave., N.e., Magee, MS 39111 | 2006-09-28 |
| 1639620560 | North Plantation | Psychiatry & Neurology | 1613 23rd Avenue, Gulfport, MS 39501 | 2016-10-15 |
| 1023363173 | Kelechi Nnamdi Emereonye | Psychiatry & Neurology | 4100 Mamie St, Hattiesburg, MS 39402-1735 | 2012-07-16 |
| 1710175260 | Clinical Neuroscience Group, Pllc | Psychiatry & Neurology | 3531 Lakeland Dr, Suite 1058, Flowood, MS 39232-8049 | 2007-10-10 |
| 1992906598 | Maecenas Inc | Psychiatry & Neurology | 206 Robert Mcdaniel Drive, Hazlehurst, MS 39083-0146 | 2007-05-30 |
| 1073684940 | Timothy Summers | Psychiatry & Neurology | 1818 College Drive, Meridian, MS 39307-5429 | 2006-11-13 |
| Find all providers with the same taxonomy | ||||
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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.