Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
DR. THEODORE A. JACKSON, M.D.
ActiveDR. THEODORE A. JACKSON, M.D. is a Plastic Surgery healthcare provider located in CHARLESTON, West Virginia. NPI 1942294376 is currently active in the NPPES registry. Verify at CMS.
Plastic Surgery · CHARLESTON, WV
Registration Details
- NPI Number
- 1942294376
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Aug 31, 2005 (20.927530585707 yrs)
- Last Updated
- Mar 12, 2009
- Licenses
-
13531 (WV)13531 (WV)
Practice Information
- Address
-
1306 KANAWHA BLVD ESUITE 100CHARLESTON, WV, 253013001Browse WV providers · Browse ZIP 25301
- Phone
- 3043421113
- Fax
- 3043462271
- Primary Specialty
-
Plastic Surgery
208200000X
- Additional Specialty
- Surgery of the Hand (Plastic)
Other Plastic Surgery Providers in CHARLESTON, WV
| Name | Credential | NPI |
|---|---|---|
| DR. WILLIAM ANDREW STEWART | MD | 1447257035 |
| DR. FRED T. PULIDO JR. | M.D. | 1114986031 |
| DR. DANIEL HUNTER STEWART | MD | 1760448195 |
| JEFFREY NORMAN THAXTON | MD | 1689755472 |
| DR. DONALD EDWARD SWEITZER | MD | 1356427496 |
| DR. WILLIAM A WOOD | MD | 1285853036 |
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.