ALTHEA J. JACKSON


Address: 2510 E Dupont Rd, Suite 100, Fort Wayne, IN 46825-1600
Phone: 2604909883

ALTHEA J. JACKSON (NPI# 1306838321) 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) 1306838321
Entity Type Individual
Full Name ALTHEA J. JACKSON
Credential M.D.
Practice Address 2510 E Dupont Rd
Suite 100
Fort Wayne
IN 46825-1600
Mailing Address 1330 Powell St
Suite 507
Norristown
PA 19401-3353
Practice Telephone 2604909883
Practice Fax Number 2604900064
Mailing Telephone 6102799003
Mailing Fax Number 6102702654
Enumeration Date 2005-08-16
Last Update Date 2007-07-08
Gender Code F
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
N 207V00000X Obstetrics & Gynecology MD040658E PA Allopathic & Osteopathic Physicians
Y 207V00000X Obstetrics & Gynecology 01052580A IN Allopathic & Osteopathic Physicians

Other Providers ALTHEA JACKSON

NPI Name Taxonomy Address Enumeration
1497002661 Althea Jackson Social Worker 22790 Sw 112th Ave, Miami, FL 33170-7602 2012-08-07
1386756500 Althea Brenda Jackson Registered Nurse 1670 Clairmont Rd, Decatur, GA 30033-4004 2006-09-01

Office Location

Street Address 2510 E DUPONT RD
SUITE 100
City FORT WAYNE
State IN
Zip Code 46825-1600

Providers in the same location

NPI Name Taxonomy Address Enumeration
1821459413 Kids.healthcare PC Pediatrics 2510 E Dupont Rd, Suite 238, Fort Wayne, IN 46825-1600 2016-03-10
1992166490 Lisa Tucker Nurse Practitioner 2510 E Dupont Rd, Suite 238, Fort Wayne, IN 46825-1600 2016-03-10
1447634449 Associated Surgeons and Physicians, LLC Pediatrics 2510 E Dupont Rd, Suite 200, Fort Wayne, IN 46825-1601 2015-07-20
1124459276 Fw Interventional Pain Management LLC Anesthesiology 2510 E Dupont Rd, Suite 115, Fort Wayne, IN 46825-1600 2013-11-27
1396080156 T-med Services, Inc Psychologist 2510 E Dupont Rd, Suite 201, Fort Wayne, IN 46825-1601 2012-12-05
1326222480 Daniel E. Krach, M.d. Eyewear Supplier (Equipment, not the service) 2510 E Dupont Rd, Suite 128, Fort Wayne, IN 46825-1600 2007-12-26
1497958946 Northeast Foot & Ankle Clinic Inc Podiatrist 2510 E Dupont Rd, Ste. 234, Fort Wayne, IN 46825-1600 2007-06-11
1013078351 Osita Victor Ezeakudo Pediatrics 2510 E Dupont Rd, Suite 200, Fort Wayne, IN 46825-1601 2006-12-12
1700809175 Arnold Brill Specialist 2510 E Dupont Rd, Fort Wayne, IN 46825-1675 2006-07-25
1558314039 Three Rivers Surgical Associates, LLC Surgery 2510 E Dupont Rd, Suite 210, Fort Wayne, IN 46825-1600 2006-05-18
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Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1336772078 Bradley Murphy Occupational Therapist 2626 St Joe Center Ed, Fort Wayne, IN 46825 2020-02-21
1144851015 Sabryna Roman Developmental Therapist 2626 St Joe Center Rd, Fort Wayne, IN 46825 2020-01-30
1205474103 Ashleigh Miller Developmental Therapist 2626 St. Joe Center Rd, Fort Wayne, IN 46825 2019-12-11
1962055152 Carehalo Ohio LLC General Practice 2510 Dupont Circle Dr., Suite 201, Fort Wayne, IN 46825 2019-07-17
1306318175 Logan Alan Williams Nurse Anesthetist, Certified Registered 10315 Dawsons Creek Blvd Ste B, Fort Wayne, IN 46825 2018-12-18
1326582925 Mark F Stoner LLC Dentist 9830 Auburn Rd Suite 102, Fort Wayne, IN 46825 2016-12-15
1336695782 Nadine Rene' Handy Nurse Practitioner 3978 New Vision Dr., Fort Wayne, IN 46825 2016-08-26
1558815712 Nathan Paul Miller Physical Therapist 10006 Auburn Park Dr, Fort Wayne, IN 46825 2016-08-05
1013366905 Brianna Abbott Physician Assistant 1234 E Dupont Rd Ste 7, Fort Wayne, IN 46825 2016-06-10
1003276643 Seiss, LLC Psychologist 9910 Dupont Circle Drive, Suite 140, Fort Wayne, IN 46825 2016-02-24
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Taxonomy Information

Taxonomy Code 207V00000X
Grouping Allopathic & Osteopathic Physicians
Classification Obstetrics & Gynecology

Taxonomy Definition

An obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women.
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 Obstetrics and Gynecology, 2007. http://www.abog.org/. American Osteopathic Board of Obstetrics and Gynecology, 2007. http://www.osteopathic.org/certification
- Board certification for Medical Doctors (MDs) is provided by the American Board of Obstetrics and Gynecology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Obstetrics and Gynecology.

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1609056779 Allen County Ob-gyn Associates, PC Obstetrics & Gynecology 800 Broadway Ste 315, Fort Wayne, IN 46802-2149 2007-11-06
1598806937 Obstetrics and Gynecology Associates of Fort Wayne PC Obstetrics & Gynecology 7802 W Jefferson Blvd, Fort Wayne, IN 46804-4138 2007-02-09
1124063102 Judy L. Zacher Obstetrics & Gynecology 3974 New Vision Drive, Fort Wayne, IN 46845-1712 2006-06-16
1275515801 Jyothirmai K Reddy Obstetrics & Gynecology 7802 W. Jefferson Blvd, Fort Wayne, IN 46804 2005-11-18
1457341182 H N Ramaprakash Obstetrics & Gynecology 7635 W Jefferson Blvd, Fort Wayne, IN 46804-4133 2005-10-25
1639168404 Kendra T Karner Obstetrics & Gynecology 11123 Parkview Plaza Dr Ste 101, Fort Wayne, IN 46845-1707 2005-10-14
1568458990 Carolyn Warner Greer Obstetrics & Gynecology 1415 Directors Row, Fort Wayne, IN 46808 2005-09-21
1588659064 Tracy L Bellavance Obstetrics & Gynecology 7988 W Jefferson Blvd, Fort Wayne, IN 46804-4140 2005-09-12
1255332664 Lora Overton Obstetrics & Gynecology 3217 Lake Ave, Fort Wayne, IN 46805-5427 2005-08-09
1285633990 Michele L Helfgott Obstetrics & Gynecology 11123 Parkview Plaza Dr, Suite 101, Fort Wayne, IN 46845-1707 2005-07-15
Find all providers in FORT WAYNE

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City FORT WAYNE
Zip Code 46825

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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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