JACKSON CLINIC PA NPI 1285629386

NPI Information

  • NPI: 1285629386
  • Provider Name: JACKSON CLINIC PA
  • Classification: Internal Medicine - 207R00000X
  • Entity Type: Organization
  • CLIA Number: 44D2008800
  • Address: 2863 HIGHWAY 45 BYP
    JACKSON, TN
    ZIP 38305
  • Phone: (731) 664-1375

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NPI Details

JACKSON CLINIC PA is an internal medicine in Jackson, TN. The provider is a physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. JACKSON CLINIC PA NPI is 1285629386. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

2863 HIGHWAY 45 BYP
JACKSON, TN
ZIP 38305-618
Phone: (731) 664-1375
Fax: (731) 664-1378

The provider's authorized official is Mark Allen .
The authorized official title is C.e.o. and has the following contact phone number (731) 422-0203.

The CLIA number assigned to this NPI record is 44D2008800 - physician office with a certificate type of Certificate of Compliance.

The enumeration date for this NPI number is 9/14/2005 and was last updated on 9/10/2025.

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 Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1152W00000XOptometristNo
2207RC0000XInternal MedicineCardiovascular DiseaseNo
3103T00000XPsychologistNo
4207W00000XOphthalmologyNo
5207V00000XObstetrics & GynecologyNo
6207RE0101XInternal MedicineEndocrinology, Diabetes & MetabolismNo
7207RG0100XInternal MedicineGastroenterologyNo
8207RP1001XInternal MedicinePulmonary DiseaseNo
9207RN0300XInternal MedicineNephrologyNo
10207RI0011XInternal MedicineInterventional CardiologyNo
11207Q00000XFamily MedicineNo
12207ND0101XDermatologyMOHS-Micrographic SurgeryNo
13207RI0200XInternal MedicineInfectious DiseaseNo
14133V00000XDietitian, RegisteredNo
15207R00000XInternal MedicineYes

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 Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
13370007MEDICAIDTENNESSEE

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: 11/21/2025

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