Keith Jackson is a Otolaryngology in Roswell, Georgia. Keith Jackson practices all healthcare services and medical treatments related to Otolaryngology. The NPI Number for Keith Jackson is 1225016454. The last update date is 2019-10-15.
Keith Jackson's current location address is 12080 Wildwood Springs Dr, Roswell, Georgia. You can contact this provider via phone number 7704753361 and fax number 7706644431. The mailing address for Keith Jackson is 12080 Wildwood Springs Dr, Roswell, Georgia. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Keith Jackson |
|---|---|
| Address | 12080 Wildwood Springs Dr, Roswell, Georgia |
| Phone Number | 7704753361 |
| Fax Number | 7706644431 |
| Sole Proprietor | N |
| Credentials | MD |
NPI Number Detail
| NPI Number | 1225016454 |
|---|---|
| Provider Enumeration Date | 2006-01-06 |
| Last Updated Date | 2019-10-15 |
Provider Mailing Address Detail
| Address | 12080 Wildwood Springs Dr |
|---|---|
| City | Roswell |
| State | Georgia (GA) |
| Post Code | 300751887 |
| Phone Number | 7704753361 |
| Fax Number | 7706644431 |
Provider's Primary Taxonomy Detail
| Speciality | Otolaryngology |
|---|---|
| Taxonomy | 207Y00000X |
| Licence No | 27575 |
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Definition: An otolaryngologist-head and neck surgeon provides comprehensive medical and surgical care for patients with diseases and disorders that affect the ears, nose, throat, the respiratory and upper alimentary systems and related structures of the head an |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 00377539B | GA | -- | |
| 00377539C | GA | -- |
Post Comment/ Review Below
What is the unique 10-digit identifier code assigned to Keith Jackson by the Centers for Medicare & Medicaid Services?
The Keith Jackson has been issued the NPI (National Provider Identifier) 1225016454 by the CMS (Centers for Medicare & Medicaid Services), which serves as a unique identification number for healthcare providers.
Could you please share the complete physical location address where Keith Jackson's facilities are situated?
The facilities of Keith Jackson are physically located at the following address: 12080 Wildwood Springs Dr, Roswell, GA, 300751887.
What is Keith Jackson's area of expertise and its corresponding taxonomy classification?
The Keith Jackson's field of specialization is Otolaryngology, and it falls under the taxonomy code 207Y00000X, which categorizes healthcare providers based on their areas of practice.
On what date did Keith Jackson receive its 1225016454 assignment from the Centers for Medicare & Medicaid Services?
The Keith Jackson was assigned its 1225016454 on 2006-01-06, which is the date when this unique identifier was issued to the organization by the Centers for Medicare & Medicaid Services.
As of what date was the information pertaining to Keith Jackson, such as address, specialty, and other details, last reviewed and confirmed to be accurate?
The information related to Keith Jackson, including its address, specialty, and other relevant details, was last reviewed and confirmed to be accurate on 2019-10-15.