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DR. JOSEPH P JACKSON M.D. NPI 1790781177


NPI Information

NPI: 1790781177
Provider Name: DR. JOSEPH P JACKSON, M.D.
Classification: Specialist - 174400000X
Entity Type: Individual

PECOS Registration: Yes

Address:
507 WALNUT ST
CAMDEN, SC
ZIP 29020
Phone: (803) 432-9300
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DR. Joseph P Jackson, M.D. is a specialist in Camden, SC. The provider is an individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. DR. Joseph P Jackson, M.D. NPI is 1790781177. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

507 WALNUT ST
CAMDEN, SC
ZIP 29020-649
Phone: (803) 432-9300
Fax: (803) 432-9307

The NPI 1790781177 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), Power Mobility Devices.

The enumeration date for this NPI number is 6/22/2005 and was last updated on 5/21/2008.


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
1174400000XSpecialist7447SOUTH 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 Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1GP0279MEDICAIDSOUTH CAROLINA
2010026253OTHERSOUTH CAROLINARAILROAD MEDICARE
3D182553560MEDICARE PINSOUTH CAROLINA
40376230001MEDICARE NSCSOUTH CAROLINA
5D182553560MEDICARE UPINSOUTH 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: 5/5/2024

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.