DR. DOROTHY LOUISE JACKSON (NPI# 1922071042) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1922071042 |
| Entity Type | Individual |
| Full Name | DR. DOROTHY LOUISE JACKSON |
| Credential | MD |
| Practice Address |
1114 W Bow St Tyler TX 75702-5137 |
| Practice Telephone | 9035955595 |
| Practice Fax Number | 9035955985 |
| Mailing Telephone | 9035955595 |
| Mailing Fax Number | 9035955985 |
| Enumeration Date | 2006-02-09 |
| Last Update Date | 2015-03-20 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | N1355 | TX | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TX | 199916104 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407364169 | Dorothy Jean Jackson | Clinic/Center | 5151 Margo Dr, Las Vegas, NV 89122-6627 | 2018-01-16 |
| 1780094664 | Dorothy Jackson | Registered Nurse | 9689 Lynns Rd, Etna, OH 43062-8493 | 2014-05-01 |
| 1487950846 | Dorothy Mae Jackson | Community Health Worker | 310 Sw 99th St, Gainesville, FL 32607-1372 | 2011-02-02 |
| 1174189773 | Dorothy Jackson | Counselor | 439 Sw Michigan St, Lake City, FL 32025-0440 | 2019-05-20 |
| 1629478417 | Dorothy Jackson | Counselor | 801 Douglas Ave, Altamonte Springs, FL 32714-5206 | 2014-08-28 |
| 1427392505 | Dorothy Octavia Jackson | Psychologist | 2002 Holcombe Blvd, Mhcl 116, Houston, TX 77030-4211 | 2012-11-15 |
| 1760789382 | Dorothy Elizabeth Jackson | Case Manager/Care Coordinator | 3944 S 400 E, Salt Lake City, UT 84107-1600 | 2011-02-16 |
| 1942521539 | Dorothy W Jackson | Social Worker | 1076 Main St, Suite 203, Fishkill, NY 12524-3606 | 2010-06-17 |
| 1568612851 | Dorothy Faye Jackson | Nurse Practitioner | 208 Nw 2nd St, Andrews, TX 79714-6308 | 2008-09-24 |
| 1467661306 | Dorothy Lyn Jackson | Student in an Organized Health Care Education/Training Program | 1646 Elmira St, Aurora, CO 80010-2122 | 2007-05-21 |
| Street Address |
1114 W BOW ST |
| City | TYLER |
| State | TX |
| Zip Code | 75702-5137 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295157337 | Phoenix Health Center, Pllc | Family Medicine | 1114 W Bow St, Tyler, TX 75702-5137 | 2014-01-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679116610 | Tiffiney Mcmakin | Nurse Practitioner | 810 E Houston St # 100, Tyler, TX 75702 | 2019-10-22 |
| 1659852507 | Krystal Gayle Lilley | Licensed Vocational Nurse | 100 E Ferguson St Ste 60a, Tyler, TX 75702 | 2018-08-28 |
| 1679029383 | Cynthia Lynn Kalawe | Physical Therapist | 100 E Ferguson, Suite 1204, Tyler, TX 75702 | 2016-09-01 |
| 1649623646 | Susan E Oxford | Social Worker | 13495 Frankston Highway, Tyler, TX 75702 | 2016-07-14 |
| 1053769281 | All Kidz Kan | Home Health | 2902 E Front St, Tyler, TX 75702 | 2016-05-27 |
| 1821415639 | Heather Mullins | Physical Therapy Assistant | 100 E. Ferguson Ste.1204, Tyler, TX 75702 | 2014-03-19 |
| 1346671336 | Dennis Keith Johnson | Dentist | 3081 Hwy. 31 East, Tyler, TX 75702 | 2013-12-02 |
| 1275882201 | Bobby Gibson | Counselor | 401 East Front Street, Ste 233, Tyler, TX 75702 | 2012-09-06 |
| 1144596792 | Tina Marie Borke | Clinical Neuropsychologist | 719 West Front St., Tyler, TX 75702 | 2012-03-28 |
| 1457629529 | James Whaley Rapp | Specialist/Technologist | 430 South Beckham Avenue, Trinity Mother Frances Sports Medicine, Tyler, TX 75702 | 2011-12-05 |
| Find all providers in zip 75702 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922632553 | Christina Kay Baker | Family Medicine | 2333 Dueling Oaks Dr, Tyler, TX 75703-0326 | 2020-02-21 |
| 1174155477 | Choice Supportive Care Team Inc. | Family Medicine | 4293 Kinsey Drive, Tyler, TX 75703 | 2020-02-05 |
| 1396389870 | Shelly Lynn Williams | Family Medicine | 1420 W Southwest Loop 323 Ste 100, Tyler, TX 75701-9347 | 2019-10-29 |
| 1891354494 | Beverly Diann Butler | Family Medicine | 5604 Old Bullard Rd Ste 107, Tyler, TX 75703-4359 | 2019-06-07 |
| 1851846018 | Thomas Mason Worthington Jr. | Family Medicine | 9141 Chisholm Trl, Tyler, TX 75703-0409 | 2016-08-17 |
| 1881069557 | The Bradley Clinic of Texas, Pllc | Family Medicine | 1402 Rice Rd, Suite 100, Tyler, TX 75703-3260 | 2015-12-07 |
| 1750764189 | Diabetic Renewal Center LLC | Family Medicine | 1015 Pruitt Pl Ste 105, Tyler, TX 75703-1154 | 2015-07-02 |
| 1013306273 | Pure Radiance Laser Retreat | Family Medicine | 6722 S Broadway Ave, Tyler, TX 75703-4730 | 2015-01-12 |
| 1023412988 | James Kent Gray | Family Medicine | 14843 Big Oak Bay Rd, Tyler, TX 75707-7309 | 2014-10-21 |
| 1346640182 | Morris Mht LLC | Family Medicine | 2030 Stonegate Blvd, Tyler, TX 75703-0103 | 2014-08-29 |
| Find all providers in TYLER | ||||
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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.