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BYRON JACKSON DPM NPI 1265516447


NPI Information

NPI: 1265516447
Provider Name: BYRON JACKSON, DPM
Classification: Podiatrist - 213E00000X
Entity Type: Individual

PECOS Registration: Yes

Address:
3310 MAGNOLIA ST
ORANGEBURG, SC
ZIP 29115
Phone: (803) 531-6900
Get Directions

Byron Jackson, DPM is a podiatrist in Orangeburg, SC with 41 years of experience. The provider is a podiatrist is a person qualified by a Doctor of Podiatric Medicine (D.P.M.) degree, licensed by the state, and practicing within the scope of that license. Podiatrists diagnose and treat foot diseases and deformities. They perform medical, surgical and other operative procedures, prescribe corrective devices and prescribe and administer drugs and physical therapy. Byron Jackson, DPM NPI is 1265516447. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

Education
Medical School: NEW YORK COLLEGE OF PODIATRIC MEDICINE
Graduation Year:1983

The provider's business location address is:

3310 MAGNOLIA ST
ORANGEBURG, SC
ZIP 29115-466
Phone: (803) 531-6900
Fax: (803) 531-6907

The NPI 1265516447 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA).

The enumeration date for this NPI number is 10/25/2006 and was last updated on 7/26/2022.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1213E00000XPodiatrist519SOUTH CAROLINAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1PD5195MEDICAIDSOUTH CAROLINA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.