DR. JEFFREY BURKE JACKSON (NPI# 1780611590) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1780611590 |
| Entity Type | Individual |
| Full Name | DR. JEFFREY BURKE JACKSON |
| Credential | M.D. |
| Practice Address |
100 Seneca Rd Elkins WV 26241-9709 |
| Mailing Address |
125 N 6th St Clarksburg WV 26301-2665 |
| Practice Telephone | 3046372777 |
| Practice Fax Number | 3046368825 |
| Mailing Telephone | 3046247200 |
| Mailing Fax Number | 3046368825 |
| Enumeration Date | 2006-06-27 |
| Last Update Date | 2015-01-23 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207N00000X | Dermatology | 16375 | WV | Allopathic & Osteopathic Physicians |
| Y | 207ND0900X |
Dermatology Specialization: Dermatopathology |
16375 | WV | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WV | 0074811000 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578193181 | Jeffrey Jackson | Student in an Organized Health Care Education/Training Program | 1055 W Longfellow Dr, Manteno, IL 60950-9472 | 2020-01-22 |
| 1881259570 | Jeffrey Lamar Jackson II | Chiropractor | 13865 S Dixie Hwy # 307, Miami, FL 33176-7221 | 2019-05-08 |
| 1548753965 | Jeffrey Jackson | Social Worker | 2024 Corporate Centre Dr Ste 103, Myrtle Beach, SC 29577-7410 | 2018-06-11 |
| 1154792422 | Jeffrey Scott Jackson | Occupational Therapy Assistant | 3209 Bristol Hwy., Nhc Healthcare, Johnson City, TN 37601 | 2015-10-13 |
| 1447481205 | Jeffrey Brown Jackson | Marriage & Family Therapist | 450 N University Ave, Suite 204, Provo, UT 84601-2860 | 2009-07-28 |
| 1952421927 | Jeffrey W Jackson | Pharmacist | 5510 Lafayette Rd Ste 260, Indianapolis, IN 46254-1691 | 2007-03-30 |
| 1659432607 | Jeffrey L Jackson | Internal Medicine | 500o W National Ave, Milwaukee, WI 53295-0001 | 2006-12-13 |
| 1760589477 | Jeffrey Scott Jackson | Pharmacist | 16821 Rosman Hwy, Lake Toxaway, NC 28747-9593 | 2006-09-17 |
| 1194764860 | Jeffrey Kline Jackson | Family Medicine | 2200 W Touhy Ave, Chicago, IL 60645-3412 | 2006-06-06 |
| 1972563443 | Jeffrey A Jackson | Internal Medicine | 720 Eskenzi Ave., Indianapolis, IN 46202-5166 | 2006-03-27 |
| Street Address |
100 SENECA RD |
| City | ELKINS |
| State | WV |
| Zip Code | 26241-9709 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689673089 | Holly S. Lee | Physician Assistant | 100 Seneca Rd, Elkins, WV 26241-9709 | 2005-07-18 |
| 1285801571 | Lori L Betler | Physician Assistant | 100 Seneca Rd, Tygart Valley Ent Associates, Elkins, WV 26241-9709 | 2008-05-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912507625 | Cindy Phillips | Technician | 2068 Files Creek Road, Elkins, WV 26241 | 2020-10-30 |
| 1316544224 | Brittany Underwood | Technician | 27 Midway Loop Rd., Elkins, WV 26241 | 2020-10-04 |
| 1740895820 | Brandie Elaine Lambert | Technician | 1 Fifth Street, Elkins, WV 26241 | 2020-09-15 |
| 1174134118 | Sherri Lynn Stahl | Technician | 36 Midland Street, Elkins, WV 26241 | 2020-08-13 |
| 1447861489 | Gwyn Esther Reynolds | Technician | 2685 Wesley Chapel Rd, Dunmore, WV 26241 | 2020-08-13 |
| 1578173092 | Stephen Foy | Technician | 216 Davis Street, Elkins, WV 26241 | 2020-08-10 |
| 1497364913 | Renee Taylor | Technician | Lot 12 Valley View Mhp, Elkins, WV 26241 | 2020-07-30 |
| 1811506959 | Roxanna E Cooper | Case Manager/Care Coordinator | #1 Fifth Street, Elkins, WV 26241 | 2020-07-24 |
| 1194379479 | Kevin Robert Lambert | Optometrist | 205 Chenoweth Creek Rd, Elkins, WV 26241 | 2019-07-25 |
| 1003318841 | Anna Foster | Nurse Practitioner | 911 Gorman Ave. #201, Elkins, WV 26241 | 2018-03-07 |
| Find all providers in zip 26241 | ||||
| Taxonomy Code | 207ND0900X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Dermatology |
| Specialization | Dermatopathology |
| A dermatopathologist has the expertise to diagnose and monitor diseases of the skin including infectious, immunologic, degenerative and neoplastic diseases. This entails the examination and interpretation of specially prepared tissue sections, cellular scrapings and smears of skin lesions by means of routine and special (electron and fluorescent) microscopes. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Dermatology, 2007. http://www.abderm.org/; American Osteopathic Board of Dermatology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Dermatology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Dermatology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942772082 | Beckley Dermatology Inc. | Dermatology | 1401 Hospital Dr Ste 101, Hurricane, WV 25526-9239 | 2018-12-31 |
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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.