DR. ANDREW BOYD JACKSON (NPI# 1497253835) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1497253835 |
Entity Type | Individual |
Full Name | DR. ANDREW BOYD JACKSON |
Credential | MD |
Practice Address |
1459 Laney Walker Blvd Augusta GA 30912 |
Mailing Address |
1465 Laney Walker Blvd Augusta GA 30912-0002 |
Practice Telephone | 7067212613 |
Practice Fax Number | 7067219081 |
Mailing Telephone | 7067212613 |
Mailing Fax Number | 2762096690 |
Enumeration Date | 2018-01-31 |
Last Update Date | 2019-07-31 |
Gender Code | M |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 207P00000X | Emergency Medicine | 10769 | GA | Allopathic & Osteopathic Physicians |
Address | Telephone Number | Fax Number |
---|---|---|
1459 Laney Walker Blvd, Augusta, GA 30912 | 7067212613 | 7067219081 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1093279572 | Andrew Jay Jackson | Technician | 125 County Road 4209, Jacksonville, TX 75766-5574 | 2019-01-29 |
1568591287 | Andrew Lee Jackson | Dentist | 600 Mccranie Avenue, Willacoochie, GA 31650 | 2007-03-06 |
1194811240 | Andrew Spencer Jackson | Dentist | 1832 Capitol St, Vallejo, CA 94590 | 2006-10-05 |
1245291954 | Andrew Dan Jackson | Chiropractor | 1025 W Carolina Ave, Hartsville, SC 29550-4427 | 2006-03-31 |
1447850227 | Andrew Jackson | Pharmacist | 3520 Hudson Dr, Stow, OH 44224-2907 | 2020-10-29 |
1528559358 | Andrew Jackson | Case Manager/Care Coordinator | 550 W Chalmers Ave, Youngstown, OH 44511-1576 | 2018-05-29 |
1134618820 | Andrew Jackson IIi | Chiropractor | 460 S 14th St, Midlothian, TX 76065-3514 | 2018-05-08 |
1285172841 | Andrew Jackson | General Acute Care Hospital | 284 N Hospital Dr, Price, UT 84501-4233 | 2017-02-03 |
1508309055 | Andrew Jackson IIi | Case Manager/Care Coordinator | 1401 Hudson Ln, Suite 202, Monroe, LA 71201-6068 | 2016-11-30 |
1285177253 | Andrew Jackson | Naturopath | 12025 Lake City Way Ne Ste B, Seattle, WA 98125-5331 | 2016-11-23 |
Street Address |
1459 LANEY WALKER BLVD |
City | AUGUSTA |
State | GA |
Zip Code | 30912 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1639158900 | Walter Jack Morris | Dentist | 1459 Laney Walker Blvd, Ad1501, Augusta, GA 30912-0002 | 2006-01-13 |
1932725694 | Liniya Tauhidul | Family Medicine | 1459 Laney Walker Blvd, Augusta, GA 30912-0002 | 2020-06-18 |
1740805852 | Nafiz Kalam Sheikh | Psychiatry & Neurology | 1459 Laney Walker Blvd, Augusta, GA 30912-0001 | 2020-06-15 |
1265057426 | Mallika Patel | Internal Medicine | 1459 Laney Walker Blvd, Augusta, GA 30912-0002 | 2020-06-13 |
1578188728 | Dhruti Prashant Diwan | Anesthesiology | 1459 Laney Walker Blvd, Augusta, GA 30912-3529 | 2020-06-13 |
1043835317 | Jesse William Wayson | Obstetrics & Gynecology | 1459 Laney Walker Blvd, Augusta, GA 30912-0002 | 2020-06-12 |
1861017139 | Mac Bohanan | Psychiatry & Neurology | 1459 Laney Walker Blvd, Augusta, GA 30912-0002 | 2020-06-12 |
1609491950 | Taylor Payne | Internal Medicine | 1459 Laney Walker Blvd, Augusta, GA 30912-0002 | 2020-06-12 |
1184249443 | Yasasvi Tadavarthi | Internal Medicine | 1459 Laney Walker Blvd, Ae 3042, Augusta, GA 30912-0004 | 2020-06-12 |
1376168807 | Erica Demaagd | Pediatrics | 1459 Laney Walker Blvd, Ae 3042, Augusta, GA 30912 | 2020-06-10 |
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NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1548885940 | Hannah Gullickson Folsom | Family Medicine | 1459 Laney Walker Blvd Ae 3042, Augusta, GA 30912 | 2020-06-11 |
1487278909 | Robert Kennedy | Internal Medicine | Augusta University Internal Medicine Residency Program, 1120 15th Street, Bi 5070, Augusta, GA 30912 | 2020-06-01 |
1952968737 | Kayla M. Lasota | Pediatrics | 11230 115th St Ae3042, Augusta, GA 30912 | 2019-05-28 |
1003379280 | Kayla Cox | Internal Medicine | 1120 15th St Bi5070, Augusta, GA 30912 | 2019-04-13 |
1619435740 | Justin Ray Mackert | Student in an Organized Health Care Education/Training Program | Augusta University, 1120 15th Street, Gc 5110, Augusta, GA 30912 | 2019-03-07 |
1417444167 | Victor Celis | Dentist | John Wesley Gilbert Dr, Augusta, GA 30912 | 2018-04-18 |
1487157921 | Julie Ann Matsen | Student in an Organized Health Care Education/Training Program | 997 St. Sebastian Way, Eg-2021-10, Augusta Univ., Dept. of Psychiatry & Health Behavior, Augusta, GA 30912 | 2018-03-12 |
1497287031 | Luke Yuung-jier Chang | Ophthalmology | 1120 15th St # Ba2720, Augusta, GA 30912 | 2017-04-02 |
1821537622 | Lashawn Kay Boone | Nurse Practitioner | 1445 Harper St, Augusta, GA 30912 | 2017-02-14 |
1134675564 | Arnab Saha | Internal Medicine | 1120 15 Th St., Augusta, GA 30912 | 2016-08-26 |
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Taxonomy Code | 207P00000X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | Emergency Medicine |
An emergency physician focuses on the immediate decision making and action necessary to prevent death or any further disability both in the pre-hospital setting by directing emergency medical technicians and in the emergency department. The emergency physician provides immediate recognition, evaluation, care, stabilization and disposition of a generally diversified population of adult and pediatric patients in response to acute illness and injury. |
Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: mofified source] - Additional Resources: American Board of Emergency Medicine, 2007. http://www.abem.org/public/; American Osteopathic Board of Emergency Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Emergency Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Emergency Medicine. |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1215310768 | John Bates Mccutcheon | Emergency Medicine | 3138 Westminster Dr, Augusta, GA 30909-3242 | 2015-07-01 |
1891114492 | Darrel Douglas | Emergency Medicine | 1120 15th St # Af-1020, Augusta, GA 30912-0004 | 2014-04-10 |
1740624774 | Desiree Brooks | Emergency Medicine | 1507 Troupe St, Apt #5, Augusta, GA 30904-5099 | 2013-04-21 |
1316258932 | Charles Robert Sheldon | Emergency Medicine | 2704 Smith Creek Rd, Augusta, GA 30909-2322 | 2010-06-29 |
1679899215 | Beau Philip Gedrick | Emergency Medicine | 1102 15th St, Augusta, GA 30912-0004 | 2010-04-07 |
1245492958 | Abhijit Singh | Emergency Medicine | 1120 15th Street Augusta University Medical Center, Augusta, GA 30912-2504 | 2008-06-25 |
1487870168 | Suzanne Joy Atteberry | Emergency Medicine | 1120 15th St Rm Af-2056, Augusta, GA 30912-0004 | 2007-04-18 |
1427086909 | Tricia-may Villanueva Harris | Emergency Medicine | 3651 Wheeler Road, Augusta, GA 30909 | 2006-06-30 |
1093758724 | George Clark Pursley | Emergency Medicine | 1219 West Wheeler Pkwy, Suite A, Augusta, GA 30909-1867 | 2006-06-13 |
1760434757 | Wakili Salihu Yarima | Emergency Medicine | 1120 15th Street Af 2036, Emergency Medicine Department, Medical College of Georgia, Augusta, GA 30912 | 2006-05-17 |
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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.