Surgery Yellow Pages

General, Orthopedic, Thoracic, Vascular Surgery
Plastic, Cosmetic, Oral, Podiatric Surgery

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DR. THEODORE A. JACKSON M.D.

Surgery Yellow Pages

Charleston, West Virginia

Provider NPI: 1942294376

Provider Information:
DR. THEODORE A. JACKSON M.D.


Practice Location:
1306 KANAWHA BLVD E SUITE 100 CHARLESTON, WV 25301 US
Tel: 304-342-1113  Fax: --

Business Mailing Address:
  ,   
Tel: --  Fax: --


Taxonomy:

PrimaryCodeCategory/DescriptionStateLicense Number
Y208200000XPhysicians
Plastic Surgery
WV13531
N2082S0105XPhysicians
Plastic Surgery
WV13531

Other Provider Identifiers:

IssuerNumberStateType
0051155000WV05
Code values:
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin



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