WILLIAM A. JACKSON JR. (NPI# 1760471130) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1760471130 |
| Entity Type | Individual |
| Full Name | WILLIAM A. JACKSON JR. |
| Credential | MD |
| Practice Address |
945 82nd Pkwy Ste 3b Myrtle Beach SC 29572-4612 |
| Mailing Address |
Po Box 3239 Florence SC 29502-3239 |
| Practice Telephone | 8438391201 |
| Practice Fax Number | 8438391202 |
| Mailing Telephone | 8438391201 |
| Mailing Fax Number | 8438391202 |
| Enumeration Date | 2005-10-19 |
| Last Update Date | 2017-01-20 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RC0000X |
Internal Medicine Specialization: Cardiovascular Disease |
21136 | SC | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| SC | 211363 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376901603 | William Jackson | Case Manager/Care Coordinator | 1001 W Broadway Ste B, Farmington, NM 87401-5638 | 2016-02-01 |
| 1104237338 | William Jackson | Surgery | 101 S Ravenel St Ste 230, Florence, SC 29506-2624 | 2014-05-09 |
| 1851646129 | William Jackson | Specialist | 5 Shorewood Ln, Centerport, NY 11721-1731 | 2012-07-23 |
| 1083904502 | William Materson Jackson | Registered Nurse | 1730 Brunswick Dr, Blacksburg, VA 24060-1988 | 2011-04-18 |
| 1912231721 | William Roland Jackson | Counselor | 2772 S. Mlk Blvd., Fresno, CA 93706-5345 | 2009-09-25 |
| 1427290667 | William E Jackson | Physician Assistant | 9261 E Northview Ct, Tucson, AZ 85749-9792 | 2009-04-02 |
| 1487846366 | William Bradley Jackson | Physical Therapy Assistant | 176 Division St, Great Barrington, MA 01230-1179 | 2007-08-14 |
| 1316144215 | William Lorenzo Jackson | Internal Medicine | 300 Rodgers Blvd, Terminal Box Unit-67, Honolulu, HI 96819-1890 | 2007-07-02 |
| 1366585226 | William Spencer Jackson | Counselor | 880 W 12th St, Reno, NV 89503-2601 | 2007-02-14 |
| 1417006594 | William Kenneth Jackson | Dentist | 11411 N Central Expy Ste K, Dallas, TX 75243-6606 | 2007-01-09 |
| Street Address |
945 82ND PKWY STE 3B |
| City | MYRTLE BEACH |
| State | SC |
| Zip Code | 29572-4612 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760485320 | Anne G. Larochelle | Internal Medicine | 945 82nd Pkwy, Myrtle Beach, SC 29572-4612 | 2005-05-27 |
| 1619523412 | Strand Physician Specialists, Pa | Physician Assistant | 945 82nd Pkwy, Myrtle Beach, SC 29572-4612 | 2019-08-16 |
| 1477111615 | Paige Alyse Weaver | Physician Assistant | 945 82nd Pkwy, Myrtle Beach, SC 29572-4612 | 2019-06-03 |
| 1306328588 | Taylor Blair Currall | Physician Assistant | 945 82nd Pkwy, Myrtle Beach, SC 29572-4612 | 2018-09-04 |
| 1528554532 | Leslie Fahy Mclamb | Nurse Practitioner | 945 82nd Pkwy, Myrtle Beach, SC 29572 | 2018-07-03 |
| 1619380623 | Rebecca Jane Heichel | Physician Assistant | 945 82nd Pkwy, Myrtle Beach, SC 29572-4612 | 2014-06-06 |
| 1194149161 | Kallie Graham Britton | Physician Assistant | 945 82nd Pkwy, Suite 3b, Myrtle Beach, SC 29572-4612 | 2014-02-12 |
| 1760823553 | Rabih Nayfe | Internal Medicine | 945 82nd Pkwy, Myrtle Beach, SC 29572-4612 | 2013-07-10 |
| 1629332911 | Ledy P Chestnut | Physician Assistant | 945 82nd Pkwy, Myrtle Beach, SC 29572-4612 | 2012-07-02 |
| 1225320666 | David L Lazar | Internal Medicine | 945 82nd Pkwy, Myrtle Beach, SC 29572-4612 | 2011-05-04 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629684576 | Matthew David Zeuschner | Nurse Practitioner | 107 Woodwind Court, Myrtle Beach, SC 29572 | 2020-09-16 |
| 1578191789 | Julia Ruth Nelson | Student in an Organized Health Care Education/Training Program | Grand Strand Medical Center- Gme Office, 809 82nd Parkway, Myrtle Beach, SC 29572 | 2020-04-01 |
| 1407484835 | Justin Schevers | Student in an Organized Health Care Education/Training Program | 802 82nd Parkway, Myrtle Beach, SC 29572 | 2020-03-31 |
| 1922636919 | Darian Michael Quigg | Student in an Organized Health Care Education/Training Program | 809 82nd Street Parkway, Myrtle Beach, SC 29572 | 2020-03-27 |
| 1881221141 | Jonathan Alden Bryan | Student in an Organized Health Care Education/Training Program | Grand Strand Medical Center, 809 82nd Parkway, Myrtle Beach, SC 29572 | 2020-03-26 |
| 1215575238 | Polaris Skin Diagnostics, LLC | Dermatology | 8170 Rourk Street, Suite 100, Myrtle Beach, SC 29572 | 2019-12-20 |
| 1700348711 | Five Star Rehabilitation and Wellness Services, LLC. | Clinic/Center | 9547 N Kings Hwy, Myrtle Beach, SC 29572 | 2019-04-01 |
| 1154882975 | Michael Kouandjio | Student in an Organized Health Care Education/Training Program | Grand Strand Medical Center-gme Office, 809 82nd Parkway, Myrtle Beach, SC 29572 | 2019-03-26 |
| 1154880102 | Dylan Chase Morgan | Internal Medicine | Grand Strand Medical Center - Gme Office, 809 82nd Pkwy, Myrtle Beach, SC 29572 | 2019-03-19 |
| 1710446828 | David Redding Kingery Jr. | Student in an Organized Health Care Education/Training Program | Gme Office 809 82nd Parkway, Myrtle Beach, SC 29572 | 2019-03-18 |
| Find all providers in zip 29572 | ||||
| Taxonomy Code | 207RC0000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Cardiovascular Disease |
| An internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threatening, abnormal heartbeat rhythms. |
| Notes: Source: American Osteopathic Board of Internal Medicine, 2008 [7/1/2008: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, http://www.abim.org/. American Osteopathic Board of Internal Medicine, https://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 |
|---|---|---|---|---|
| 1750544680 | Kay Goring | Internal Medicine | 2215 Brewster Dr, Myrtle Beach, SC 29577-1748 | 2008-07-10 |
| 1245752294 | Mcleod Physician Associates II | Internal Medicine | 907 Startek Dr, Myrtle Beach, SC 29579-4471 | 2017-07-12 |
| 1124481296 | Veritas Executive Healthcare | Internal Medicine | 5046 Highway 17 Byp S, Suite 100, Myrtle Beach, SC 29588-4503 | 2016-04-05 |
| 1124442611 | Veritas Healthcare Solutions, LLC | Internal Medicine | 5046 Highway 17 Byp S, Suite 100, Myrtle Beach, SC 29588-4503 | 2014-02-05 |
| 1891060802 | Barry H Hellman | Internal Medicine | 4600 Oleander Dr, Suite 2a, Myrtle Beach, SC 29577-5897 | 2012-03-09 |
| 1831414135 | Strand Physician Specialists, Pa | Internal Medicine | 809 82nd Parkway, Myrtle Beach, SC 29572 | 2010-03-30 |
| 1225233497 | Omar Jaraki | Internal Medicine | 4420 Oleander Dr, Myrtle Beach, SC 29577-5720 | 2007-06-18 |
| 1033290440 | Anthony James Bashall | Internal Medicine | 920 Doug White Dr Ste 510, Myrtle Beach, SC 29572-4183 | 2006-10-19 |
| 1497784185 | Vaishali M Swami | Internal Medicine | 945 82nd Pkwy, Myrtle Beach, SC 29572-4612 | 2006-07-03 |
| 1750379202 | Erol Lale | Internal Medicine | 207 Chartwell Ct, Myrtle Beach, SC 29588-9999 | 2005-10-10 |
| Find all providers in MYRTLE BEACH | ||||
| City | MYRTLE BEACH |
| Zip Code | 29572 |
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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.