DR. DONALD WILLIAM JACKSON (NPI# 1760500649) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1760500649 |
| Entity Type | Individual |
| Full Name | DR. DONALD WILLIAM JACKSON |
| Practice Address |
1909 A Mission 66 Vicksburg MS 39180-3711 |
| Practice Telephone | 6016368003 |
| Practice Fax Number | 6016389602 |
| Mailing Telephone | 6016368003 |
| Mailing Fax Number | 6016389602 |
| Enumeration Date | 2007-03-27 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223G0001X |
Dentist Specialization: General Practice |
184079 | MS | Dental Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700200086 | Donald Jackson Jr. | Preventive Medicine | 2500 E Grand Blvd, Medical Dept, Detroit, MI 48211-2006 | 2014-02-07 |
| 1942577200 | Donald Jefferson Jackson | Social Worker | 434 Atkinson St, Laurinburg, NC 28352-3714 | 2011-11-30 |
| 1366684839 | Donald Wayne Jackson | Case Manager/Care Coordinator | 3434 Mount Burnside Way, Woodbridge, VA 22192-1013 | 2009-03-30 |
| 1588722466 | Donald A Jackson | Psychologist | Nced Ms 285, University of Nevada, Reno, Reno, NV 89557-1285 | 2006-12-05 |
| 1215310115 | Donald Lee Jackson Jr. | Counselor | 1030 Village Dr Ste B, Watkinsville, GA 30677-6004 | 2015-07-09 |
| 1811185721 | Donald John Jackson | Social Worker | 63 Harmony Hill Rd, Chepachet, RI 02814-1429 | 2007-10-05 |
| 1588876965 | Donald Murphy Jackson | Dentist | 712 S Main St, North East, MD 21901-4126 | 2007-05-05 |
| 1609997584 | Donald L Jackson | Counselor | 1012 14th St Nw, Suite 1000, Washington, DC 20005-3403 | 2007-04-02 |
| 1407947039 | Donald J. Jackson | Physician Assistant | 185 Grafton Rd., Townshend, VT 05353 | 2006-09-27 |
| 1740238153 | Donald E Jackson Jr. | Radiology | 6716 Nw 11th Place, Ste 200, Gainesville, FL 32605-4215 | 2006-05-05 |
| Street Address |
1909 A MISSION 66 |
| City | VICKSBURG |
| State | MS |
| Zip Code | 39180-3711 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255877346 | Elite Performance and Rehab, LLC | Clinic/Center | 1901 A Mission 66, Vicksburg, MS 39180 | 2017-01-12 |
| 1679931083 | Heather M Anderson | Physician Assistant | 2080 S Frontage Rd Ste 100, Vicksburg, MS 39180 | 2016-02-01 |
| 1245604941 | Warren County Assn.for Retarded Citizens, Inc. | Day Training, Developmentally Disabled Services | 100 Smokey Lane, Vicksburg, MS 39180 | 2015-11-18 |
| 1386012904 | Brian Oliver Snowden | Counselor | 3530 Manor Dr Ste 5a, Vicksburg, MS 39180 | 2015-09-14 |
| 1962802710 | Jordan P. Crocker, D.m.d., Pllc | Clinic/Center | 109 Monument Place, Vicksburg, MS 39180 | 2014-08-29 |
| 1821434259 | Trisha Addison | Physical Therapist | 2222 South Frontage Road, Suite D, Vicksburg, MS 39180 | 2013-05-13 |
| 1073862157 | Laura Jeanne Briggs | Physical Therapist | 1901-a Mission 66, Vicksburg, MS 39180 | 2012-09-05 |
| 1912175258 | Andrea T. Harris | Counselor | Warren-yazoo Mental Health Service, 3444 Wisconsin Ave., Vicksburg, MS 39180 | 2008-02-20 |
| 1922217314 | Austin Family Dentistry | Dentist | 3040 Indiana Ave, Vicksburg, MS 39180 | 2007-05-22 |
| 1063539138 | Ollie Hardaway Jr. | Dentist | 154 Cottonwood Street, Vicksburg, MS 39180 | 2007-03-23 |
| Find all providers in zip 39180 | ||||
| Taxonomy Code | 1223G0001X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | General Practice |
| A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. |
| Notes: Source: Academy of General Dentistry |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649626573 | Vicksburg Family Dental 61n | Dentist | 1650 Highway 61 N, Vicksburg, MS 39183-3522 | 2016-05-10 |
| 1982952115 | Jordan P Crocker | Dentist | 109 Monument Pl, Vicksburg, MS 39180-5161 | 2012-08-20 |
| 1922217314 | Austin Family Dentistry | Dentist | 3040 Indiana Ave, Vicksburg, MS 39180 | 2007-05-22 |
| 1992910244 | Kurt R Schrock I | Dentist | 1903 Mission 66, Vicksburg, MS 39180-3711 | 2007-05-11 |
| 1649492695 | Charles Brent Thomas | Dentist | 1805 Mission 66, Vicksburg, MS 39180-3709 | 2007-05-02 |
| 1962523944 | Robert M Abraham, D.d.s., P.a. | Dentist | 1909 Mission 66, Vicksburg, MS 39180-3711 | 2007-04-03 |
| 1891812731 | Lemont Terrance Norris | Dentist | 1713 Clay St, Ste 5, Vicksburg, MS 39183-3048 | 2007-03-24 |
| 1366582413 | Robert A Sadler | Dentist | 1016 Mission 66, Vicksburg, MS 39183-2752 | 2007-02-07 |
| 1821150194 | Martin V Chaney | Dentist | 3205 Wisconsin Ave, Vicksburg, MS 39180-5350 | 2006-12-14 |
| 1740353408 | Ballard Dental Group | Dentist | 3040 Indiana Avenue, Vicksburg, MS 39180 | 2006-11-17 |
| Find all providers in VICKSBURG | ||||
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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.