LAIRD JACKSON (NPI# 1568647592) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1568647592 |
| Entity Type | Individual |
| Full Name | LAIRD JACKSON |
| Credential | MD |
| Practice Address |
216 N Broad St Philadelphia PA 19102-1121 |
| Mailing Address |
1601 Cherry St Philadelphia PA 19102-1321 |
| Practice Telephone | 2187623600 |
| Mailing Telephone | 2152557822 |
| Mailing Fax Number | 2152557825 |
| Enumeration Date | 2008-01-09 |
| Last Update Date | 2008-01-09 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207V00000X | Obstetrics & Gynecology | MD005860E | PA | Allopathic & Osteopathic Physicians |
| Street Address |
216 N BROAD ST |
| City | PHILADELPHIA |
| State | PA |
| Zip Code | 19102-1121 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780667154 | Norman A Johanson | Orthopaedic Surgery | 216 N Broad St, 2nd Floor, Philadelphia, PA 19102-1121 | 2005-11-21 |
| 1104192558 | Gregory Malat | Pharmacist | 216 N Broad St, Ms 417 5th Floor Feinstein Bldg, Philadelphia, PA 19102-1121 | 2012-03-30 |
| 1841569167 | Andres Riera | Internal Medicine | 216 N Broad St, Philadelphia, PA 19102 | 2011-12-14 |
| 1376810192 | Roberto Eduarte Velasco | Nurse Practitioner | 216 N Broad St, 12318 New College Building, Philadelphia, PA 19102-1121 | 2011-11-22 |
| 1972886885 | Priscilla Bosacco | Nurse Practitioner | 216 N Broad St, Feinstein Building, 2nd Floor, Philadelphia, PA 19102-1121 | 2011-09-27 |
| 1972747285 | Jasjit Kaur Beausang | Obstetrics & Gynecology | 216 N Broad St, Floor 4 Feinstein Building, Philadelphia, PA 19102-1121 | 2009-04-30 |
| 1215192521 | Karen M Berkowitz | Obstetrics & Gynecology | 216 N Broad St, 4th Floor, Philadelphia, PA 19102-1121 | 2008-07-25 |
| 1417135161 | Philadelphia Health & Education Corporation | Obstetrics & Gynecology | 216 N Broad St, 4th Floor, Feinstein, Philadelphia, PA 19102-1121 | 2008-02-05 |
| 1023227444 | Lissa Beth Levin Mizrahi | Internal Medicine | 216 N Broad St, 5th Floor, Philadelphia, PA 19102-1121 | 2007-05-22 |
| 1558575894 | M. Velma Weitz | Nurse Practitioner | 216 N Broad St, Philadelphia, PA 19102-1121 | 2007-05-09 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821650847 | Alexandre Mason Sharma | Student in an Organized Health Care Education/Training Program | 200 N 16th St Apt 1318, Philadelphia, PA 19102 | 2019-06-29 |
| 1720648223 | Ali Haydar | Internal Medicine | 245 N. 15th St, 6th Floor, Ms 42, Philadelphia, PA 19102 | 2019-06-17 |
| 1124688734 | Aakash Patel | Internal Medicine | Drexel University College of Medicine-internal Medicine, 245 N. 15th St. 6th Floor, Ms 427, Philadelphia, PA 19102 | 2019-06-17 |
| 1245898170 | Parth Javia | Internal Medicine | 245 N. 15th St., 6th Floor, Ms 427, Philadelphia, PA 19102 | 2019-06-05 |
| 1588120968 | John Granger II | Social Worker | 1500 Market St. 12th Floor Suite 75, Philadelphia, PA 19102 | 2019-02-11 |
| 1750851390 | Philadelphia Pain and Neurology Institute, LLC | Chiropractor | 1528 Walnut Street Suite 620, Philadelphia, PA 19102 | 2018-11-27 |
| 1770076465 | Sarthi Dalal | Internal Medicine | 245 N 15th St, Fl 6, Ms 427, Philadelphia, PA 19102 | 2018-06-07 |
| 1255824033 | Joyce Nimo-boampong | Internal Medicine | Drexel University College of Medicine, 245 N 15th St, 6th Floor,ms 427, Philadelphia, PA 19102 | 2018-06-07 |
| 1134625692 | Emma Rose Gormley | Social Worker | 1601 Walnut St Ste 1516, Philadelphia, PA 19102 | 2018-04-03 |
| 1851808497 | Sunish Shah | Pharmacist | 230 N Broad St, Philadelphia, Pa 19102, Philadelphia, PA 19102 | 2018-01-04 |
| Find all providers in zip 19102 | ||||
| Taxonomy Code | 207V00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Obstetrics & Gynecology |
| An obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Obstetrics and Gynecology, 2007. http://www.abog.org/. American Osteopathic Board of Obstetrics and Gynecology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Obstetrics and Gynecology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Obstetrics and Gynecology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962027557 | Tal Avigal Lee | Obstetrics & Gynecology | 1109 Green St Apt 11, Philadelphia, PA 19123-3326 | 2020-06-10 |
| 1396303962 | Medical Foundation Inc | Obstetrics & Gynecology | Rush Medical Group / Philadelphia, 1106 Central Drive, Ste 3, Philadelphia, MS 39350 | 2019-05-30 |
| 1477011401 | Diane D. Harrison | Obstetrics & Gynecology | 236 Philip Pl, Philadelphia, PA 19106-3902 | 2019-03-08 |
| 1720570963 | Tiffany Fernandes Gee | Obstetrics & Gynecology | 3401 N Broad St Fl 7, Philadelphia, PA 19140-5189 | 2018-06-04 |
| 1881114742 | Andrea Jasmine Leung | Obstetrics & Gynecology | 5501 Old York Rd # 1-1616, Philadelphia, PA 19141-3018 | 2017-06-22 |
| 1548798093 | Dimitrios Nasioudis | Obstetrics & Gynecology | 3400 Spruce Street, 1 West Gates, Hellen O. Dickens Center for Women's Health, Philadelphia, PA 19104-3123 | 2017-05-30 |
| 1811449697 | West Cayuga Medicine PC | Obstetrics & Gynecology | 257 W Cayuga St, Philadelphia, PA 19140-2439 | 2016-10-27 |
| 1447631536 | Clinton Veselis | Obstetrics & Gynecology | 3401 N Broad St Dept Of, Philadelphia, PA 19140 | 2015-06-15 |
| 1811378979 | Nishanth Sidduri | Obstetrics & Gynecology | 400 W Allegheny Ave Ste 5b, Philadelphia, PA 19133-3614 | 2015-06-15 |
| 1396158820 | Elizabeth Carey Banks | Obstetrics & Gynecology | 800 Walnut St Fl 12, Philadelphia, PA 19107-5176 | 2014-06-02 |
| Find all providers in PHILADELPHIA | ||||
| City | PHILADELPHIA |
| Zip Code | 19102 |
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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.