MR. GARY DEAN JACKSON (NPI# 1609426022) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1609426022 |
| Entity Type | Individual |
| Full Name | MR. GARY DEAN JACKSON |
| Credential | R.PH. |
| Practice Address |
11340 Three Rivers Rd Ste A Gulfport MS 39503-3650 |
| Practice Telephone | 2288328000 |
| Practice Fax Number | 2288320808 |
| Mailing Telephone | 2288328000 |
| Mailing Fax Number | 2288320808 |
| Enumeration Date | 2019-09-17 |
| Last Update Date | 2019-09-17 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 183500000X | Pharmacist | E-06793 | MS | Pharmacy Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033462932 | Gary D Jackson | Counselor | 4610 Santa Anita Blvd, Suite D, El Monte, CA 91731 | 2012-10-17 |
| 1720317688 | Gary Howard Jackson | Orthopaedic Surgery | 38 Bent Pebble Pt, Lumberton, MS 39455-9037 | 2009-12-23 |
| 1578692331 | Gary L. Jackson | Internal Medicine | Lincoln County Medical Center, 211 Sudderth, Ruidoso, NM 88345 | 2007-03-05 |
| 1447237839 | Gary Lee Jackson | Chiropractor | 20595 Sw Tv Hwy #102, Ste 102, Aloha, OR 97006 | 2005-12-27 |
| 1992119838 | Gary Chase Jackson | Optometrist | 6030 W University Blvd, Odessa, TX 79764 | 2014-06-18 |
| 1154528263 | Gary Wayne Jackson | Physician Assistant | 1804 College Ave, Levelland, TX 79336-6507 | 2007-07-02 |
| 1447473772 | Gary Jackson | Counselor | 1756 S Lewis Rd, Camarillo, CA 93012-8520 | 2007-04-11 |
| 1700884947 | Gary L Jackson | Nurse Anesthetist, Certified Registered | 4100 Summerhill Rd, Texarkana, TX 75503-2732 | 2005-07-12 |
| Street Address |
11340 THREE RIVERS RD STE A |
| City | GULFPORT |
| State | MS |
| Zip Code | 39503-3650 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568669208 | Jackson's Discount Pharmacy, Inc. | Pharmacy | 11340 Three Rivers Rd Ste A, Gulfport, MS 39503-3650 | 2007-06-27 |
| 1639729080 | Bennie Dan Mcgrew | Pharmacist | 11340 Three Rivers Rd Ste A, Gulfport, MS 39503-3650 | 2019-09-18 |
| 1457901803 | Elvin Wayne Mills | Pharmacist | 11340 Three Rivers Rd Ste A, Gulfport, MS 39503-3650 | 2019-09-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013515451 | Gulf Coast Neurospa, LLC | Psychiatry & Neurology | 8845 Lorraine Road, Gulfport, MS 39503 | 2020-10-16 |
| 1447865985 | Nicholas Wyrosdick | Physical Therapist | 12261 Us 49 #1, Gulfport, MS 39503 | 2020-09-11 |
| 1750935169 | Ladner Roy Drugs, LLC. | Pharmacy | 12261 Us 49 Suite 16, Gulfport, MS 39503 | 2019-07-25 |
| 1528559440 | Alexander Therapy Services, LLC | Clinic/Center | 15465 Oak Ln Ste 100c, Gulfport, MS 39503 | 2018-05-25 |
| 1750879003 | Heather Lynn Theisen | Nurse Practitioner | 15190 Community Rd Ste 330, Gulfport, MS 39503 | 2018-04-23 |
| 1083101216 | Gulf Coast Mental Health Center | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 15094 County Barn Road, Gulfport, MS 39503 | 2018-04-13 |
| 1306343173 | Dr. Raymond Monsour Scurfield, LLC | Community/Behavioral Health | 15465 Oak Lane Ste 100-g, Gulfport, MS 39503 | 2018-04-09 |
| 1952817157 | Mary Beth Welch | Behavioral Analyst | 9230 Old Lorraine Rd, Gulfport, MS 39503 | 2017-12-26 |
| 1831603257 | Beach View Family Dental, Pllc | Dentist | 9072 Lorraine Road, Gulfport, MS 39503 | 2017-11-21 |
| 1437677721 | Mary Stephens Ruffin | Social Worker | 11262 Creek Dr, Gulfport, MS 39503 | 2017-09-07 |
| Find all providers in zip 39503 | ||||
| Taxonomy Code | 183500000X |
| Grouping | Pharmacy Service Providers |
| Classification | Pharmacist |
| An individual licensed by the appropriate state regulatory agency to engage in the practice of pharmacy. The practice of pharmacy includes, but is not limited to, assessment, interpretation, evaluation, and implementation, initiation, monitoring or modification of medication and or medical orders; the compounding or dispensing of medication and or medical orders; participation in drug and device procurement, storage, and selection; drug administration; drug regimen reviews; drug or drug-related research; provision of patient education and the provision of those acts or services necessary to provide medication therapy management services in all areas of patient care. |
| Notes: Source: Adapted from National Association of Boards of Pharmacy Model State Pharmacy Act, Article 1, Section 104. [1/1/2006: definition modified, source modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225637424 | Milagros H. Walker | Pharmacist | 2119 Lindhridge Dr, Gulfport, MS 39507-3765 | 2020-10-20 |
| 1508373259 | Raikeisha Harper | Pharmacist | 1520 Broad Ave Ste 300, Gulfport, MS 39501-3601 | 2018-01-03 |
| 1457744856 | Lesley Eura Spencer | Pharmacist | 2433 25th Ave, Gulfport, MS 39501-4525 | 2015-03-09 |
| 1487065355 | Huong Nguyen | Pharmacist | 2433 25th Avenue, Gulfport, MS 39501 | 2014-05-14 |
| 1366872491 | William Alexis Marcia | Pharmacist | 1444 East Pass Road, Gulfport, MS 39507 | 2013-11-27 |
| 1205272184 | Racheal Latoya Jones | Pharmacist | 505 Lipscomb Ct, Gulfport, MS 39507-2868 | 2013-05-17 |
| 1033409404 | Carl Vonbodungen | Pharmacist | 11179 Highway 49, Gulfport, MS 39503 | 2011-04-19 |
| 1124327044 | Lakeisha J Jackson-patton | Pharmacist | 11279 Highway 49, Gulfport, MS 39503-3396 | 2011-03-17 |
| 1023323235 | Steven James Juraszek | Pharmacist | 2 Pass Rd, Gulfport, MS 39507-3201 | 2010-08-11 |
| 1336326636 | Janelle E Joe | Pharmacist | 11312 Highway 49, Gulfport, MS 39503-3086 | 2008-01-29 |
| Find all providers in GULFPORT | ||||
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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.