WILLIAM JACKSON (NPI# 1104237338) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1104237338 |
| Entity Type | Individual |
| Full Name | WILLIAM JACKSON |
| Credential | D.O. |
| Practice Address |
101 S Ravenel St Ste 230 Florence SC 29506-2624 |
| Practice Telephone | 8437777043 |
| Practice Fax Number | 8437777041 |
| Mailing Telephone | 8437777043 |
| Mailing Fax Number | 8437777041 |
| Enumeration Date | 2014-05-09 |
| Last Update Date | 2019-07-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2086S0129X |
Surgery Specialization: Vascular Surgery |
82162 | SC | Allopathic & Osteopathic Physicians |
| N | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376901603 | William Jackson | Case Manager/Care Coordinator | 1001 W Broadway Ste B, Farmington, NM 87401-5638 | 2016-02-01 |
| 1851646129 | William Jackson | Specialist | 5 Shorewood Ln, Centerport, NY 11721-1731 | 2012-07-23 |
| 1083904502 | William Materson Jackson | Registered Nurse | 1730 Brunswick Dr, Blacksburg, VA 24060-1988 | 2011-04-18 |
| 1912231721 | William Roland Jackson | Counselor | 2772 S. Mlk Blvd., Fresno, CA 93706-5345 | 2009-09-25 |
| 1427290667 | William E Jackson | Physician Assistant | 9261 E Northview Ct, Tucson, AZ 85749-9792 | 2009-04-02 |
| 1487846366 | William Bradley Jackson | Physical Therapy Assistant | 176 Division St, Great Barrington, MA 01230-1179 | 2007-08-14 |
| 1316144215 | William Lorenzo Jackson | Internal Medicine | 300 Rodgers Blvd, Terminal Box Unit-67, Honolulu, HI 96819-1890 | 2007-07-02 |
| 1366585226 | William Spencer Jackson | Counselor | 880 W 12th St, Reno, NV 89503-2601 | 2007-02-14 |
| 1417006594 | William Kenneth Jackson | Dentist | 11411 N Central Expy Ste K, Dallas, TX 75243-6606 | 2007-01-09 |
| 1326109661 | William Jackson Jr. | Optometrist | 4 West Way Court, Lake Jackson, TX 77566-5242 | 2006-12-12 |
| Street Address |
101 S RAVENEL ST STE 230 |
| City | FLORENCE |
| State | SC |
| Zip Code | 29506-2624 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871001693 | Med Way Ambulance Service, LLC | Ambulance | 1627 E Palmetto St, Florence, SC 29506 | 2018-01-15 |
| 1851810261 | Daijavon Jaquita Mccall | Specialist/Technologist | 1207 Malloy Street, Florence, SC 29506 | 2017-09-18 |
| 1629453873 | Rebecca Diboni | Pharmacist | 501 E Cheves St, Suite D, Florence, SC 29506 | 2015-07-29 |
| 1710365846 | Tiffany Joann Williams | Counselor | 205 Pearl Cir Florence, Sc, SC 29506 | 2015-05-08 |
| 1275925091 | Joe Brice Williamson Jr. | Pharmacist | 501 E. Cheves St., Suite D, Florence, SC 29506 | 2015-03-03 |
| 1528474632 | La'keisha Coker | Dietitian, Registered | 145 E. Cheves St., Florence County Health Department, Florence, SC 29506 | 2014-07-09 |
| 1275948085 | Patrick Kevin Mccarthy | Dietitian, Registered | 145 East Cheves Street, Florence County Health Dept., Florence, SC 29506 | 2014-07-01 |
| 1073931655 | Gwen A Davis | Registered Nurse | 145 E Cheves Street, Sc Dhec Pee Dee Region, Florence, SC 29506 | 2014-04-01 |
| 1205267879 | Jessica Turner | Physical Therapist | 555 E Cheves St., Inpatient Rehab Department, Florence, SC 29506 | 2013-12-09 |
| 1700213923 | Pamela Orange | Nurse's Aide | 2501 Sparklberry Lane, Florence, SC 29506 | 2013-10-02 |
| Find all providers in zip 29506 | ||||
| Taxonomy Code | 2086S0129X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Surgery |
| Specialization | Vascular Surgery |
| A surgeon with expertise in the management of surgical disorders of the blood vessels, excluding the intracranial vessels or the heart. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Surgery, 2007. http://www.absurgery.org/. American Osteopathic Board of Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184976789 | Mcleod Physician Associates II | Surgery | 901 E Cheves St, Suite 430, Florence, SC 29506-2716 | 2012-10-05 |
| 1285900597 | Brian Paul Fletcher | Surgery | 2129 Helton Dr, Florence, AL 35630 | 2012-03-30 |
| 1073826624 | Carmen Michael Piccolo IIi | Surgery | 101 S Ravenel St, Suite 230, Florence, SC 29506-2618 | 2010-07-23 |
| 1699787523 | Eva Maria Rzucidlo | Surgery | 101 S Ravenel St, Suite 230, Florence, SC 29506-2618 | 2006-08-12 |
| 1619994233 | Mcleod Physician Associates II | Surgery | 800 E Cheves St, Ste 260, Florence, SC 29506-2652 | 2006-07-17 |
| 1932155306 | The Health Care Authority of Lauderdale County & The City of Florence | Surgery | 541 W College St, Suite 2000, Florence, AL 35630-5323 | 2006-05-26 |
| 1104899145 | Mcleod Physician Associates II | Surgery | 101 South Ravenel Street, Suite 270, Florence, SC 29506-2610 | 2006-02-09 |
| 1205814019 | Peter John Pons | Surgery | 541 W College St, Suite 2000, Florence, AL 35630-5323 | 2006-01-03 |
| 1558351122 | Christopher G Cunningham | Surgery | 101 S Ravenel St, Suite 230, Florence, SC 29506-2644 | 2005-10-25 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740840024 | Tyler Buckley | Surgery | 169 Ashley Ave, Room 202 Main Hospital, Msc333, Charleston, SC 29425 | 2019-06-18 |
| 1043766017 | Charleston Vascular Surgery, P.C. | Surgery | 1280 Hospital Drive, Suite 302, Charleston Vascular Surgery, P.C., Mount Pleasant, SC 29464-1901 | 2016-08-30 |
| 1962765081 | Goatee Vascular LLC | Surgery | 4036 River Oaks Dr, Unit B2, Myrtle Beach, SC 29579-6695 | 2012-06-22 |
| 1518149350 | Thomas Russell Wieters, M.d., P.a. | Surgery | 3070 Highway 17 N, Suite 202, Mount Pleasant, SC 29466-9300 | 2007-12-04 |
| 1801985007 | Thomas C. Appleby | Surgery | 1327 Ashley River Road, Building B, Charleston, SC 29407 | 2006-10-12 |
| 1962519546 | Mary Black Health System LLC | Surgery | 1690 Skylyn Dr Ste 350, Spartanburg, SC 29307-1039 | 2006-08-23 |
| 1164536215 | Sean J Hislop | Surgery | 1327 Ashley River Rd, Charleston, SC 29407-5384 | 2006-08-18 |
| 1881600963 | Louis F Knoepp IIi | Surgery | 100 Health Way, Suite 1240, Anderson, SC 29621-7917 | 2006-07-31 |
| 1659321115 | Robert C. Allen | Surgery | 197 Piedmont Blvd Ste 100, Rock Hill, SC 29732-1824 | 2006-05-12 |
| 1164496527 | The Regional Medical Center of Orangeburg and Calhoun Counties | Surgery | 1175 Cook Rd Ste 320, Orangeburg, SC 29118-8247 | 2006-02-14 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.