DR. EDWARD ROBERT JACKSON II (NPI# 1710129408) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1710129408 |
| Entity Type | Individual |
| Full Name | DR. EDWARD ROBERT JACKSON II |
| Credential | MD |
| Practice Address |
3334 Capital Medical Blvd #400 Tallahassee FL 32308-4470 |
| Practice Telephone | 8508778174 |
| Practice Fax Number | 8508775636 |
| Mailing Telephone | 8508778174 |
| Mailing Fax Number | 8508775636 |
| Enumeration Date | 2009-03-27 |
| Last Update Date | 2016-04-05 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207X00000X | Orthopaedic Surgery | 063075 | GA | Allopathic & Osteopathic Physicians |
| Y | 207X00000X | Orthopaedic Surgery | ME107624 | FL | Allopathic & Osteopathic Physicians |
| N | 207X00000X | Orthopaedic Surgery | BP10016960 | TX | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | UNIVERSAL HEALTHCARE | 250872 | 01 |
| GA | RR MEDICARE | P00903177 | 01 |
| FL | 002458400 | 05 | |
| GA | 503370302B | 05 | |
| FL | UNITED HEALTH CARE | 003214650 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669095899 | Edward Winston Jackson Iv | Behavior Technician | 1715 Vista Del Norte, Chino Hills, CA 91709-5179 | 2020-05-21 |
| 1477640373 | Edward Michael Jackson | Dentist | 405 State St, Hackensack, NJ 07601-4421 | 2006-10-10 |
| 1295835932 | Edward L. Jackson | Chiropractor | 302 S West Outer Rd, Suite C, Archie, MO 64725-9710 | 2006-09-23 |
| 1639104029 | Edward A Jackson | Family Medicine | 7975 Lake Underhill Rd Ste 200, Orlando, FL 32822-8204 | 2006-07-12 |
| 1285611707 | Edward Lawrence Jackson | Pharmacist | Wamc Stop A 2817 Reilly Rd, Mcxc Ph, Fort Bragg, NC 28310-0001 | 2005-12-27 |
| 1649879743 | Edward Jackson Jr. | Marriage & Family Therapist | 9070 Main St, Clarence, NY 14031-1825 | 2020-10-20 |
| 1932652609 | Edward Jackson | Technician/Technologist | 479 Old Union Tpke, Lancaster, MA 01523-3029 | 2016-07-29 |
| 1043606213 | Edward Jackson | Psychologist | 11111 Hall Rd, #303, Utica, MI 48317-5711 | 2015-04-14 |
| 1083816326 | Edward Jackson | Counselor | 3007 Telegraph Ave, Oakland, CA 94609-3205 | 2007-05-31 |
| 1144389917 | Edward L Jackson Jr. | Counselor | 7750 Clayton Rd, Suite 103, Saint Louis, MO 63117-1353 | 2006-12-08 |
| Street Address |
3334 CAPITAL MEDICAL BLVD #400 |
| City | TALLAHASSEE |
| State | FL |
| Zip Code | 32308-4470 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518934694 | Hank Lawrence Hutchinson | Orthopaedic Surgery | 3334 Capital Medical Blvd #400, Tallahassee, FL 32308-4470 | 2006-03-07 |
| 1619391802 | Mark Gibson | Orthotist | 3334 Capital Medical Blvd #400, Tallahassee, FL 32308-4470 | 2014-02-10 |
| 1528145356 | Kimberly R Hagen | Nurse Practitioner | 3334 Capital Medical Blvd #400, Tallahassee, FL 32308 | 2006-11-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215588306 | Jmc Tallahassee, LLC | Preventive Medicine | 1838 Jacliff Court, Tallahassee, FL 32308 | 2019-09-20 |
| 1972165108 | Covenant Home Health Care, LLC | Home Health | 1921 Capital Circle Ne, Tallahassee, FL 32308 | 2019-07-09 |
| 1548735798 | North Florida Rehab Solutions | Hospitalist | 1675 Riggins Road, Dr Steele Lancaster, Tallahassee, FL 32308 | 2018-10-03 |
| 1013491596 | Injury and Rehab Centers of North Florida, LLC | Neuromusculoskeletal Medicine & OMM | 2268 Wednesday Street, Tallahassee, Florida, FL 32308 | 2018-09-20 |
| 1487133625 | Genoa Healthcare, LLC | Durable Medical Equipment & Medical Supplies | 2634 Capital Circle Ne, Building C, Suite 156, Tallahassee, FL 32308 | 2018-08-08 |
| 1629566724 | Total Health & Wellness Home Care, LLC | Home Health | 1325 Mahan Dr., Tallahassee, FL 32308 | 2018-04-25 |
| 1669979480 | Beth North, Lcsw, LLC | Social Worker | 1325 Mahan Drive, Tallahassee, FL 32308 | 2018-04-09 |
| 1750885919 | Robert E Ashmore Jr Md | Obstetrics & Gynecology | 2770 Capitol Medical Blvd, Suite 100, Tallahassee, FL 32308 | 2018-03-22 |
| 1225547243 | William Michael Kunkle | Physician Assistant | 4004 Norton Ln, Suite 101, Tallahassee, FL 32308 | 2017-09-21 |
| 1235657834 | Traci R Raybon | Occupational Therapist | 1924 Hidden Valley, Tallahassee, FL 32308 | 2017-09-03 |
| Find all providers in zip 32308 | ||||
| Taxonomy Code | 207X00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Orthopaedic Surgery |
| An orthopaedic surgeon is trained in the preservation, investigation and restoration of the form and function of the extremities, spine and associated structures by medical, surgical and physical means. An orthopaedic surgeon is involved with the care of patients whose musculoskeletal problems include congenital deformities, trauma, infections, tumors, metabolic disturbances of the musculoskeletal system, deformities, injuries and degenerative diseases of the spine, hands, feet, knee, hip, shoulder and elbow in children and adults. An orthopaedic surgeon is also concerned with primary and secondary muscular problems and the effects of central or peripheral nervous system lesions of the musculoskeletal system. |
| 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 Orthopaedic Surgery, 2007. http://www.abos.org/. American Osteopathic Board of Orthopaedic Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Orthopaedic Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Orthopaedic Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952713646 | Kyle Mobley | Orthopaedic Surgery | 2605 Welaunee Blvd, Tallahassee, FL 32308-4697 | 2014-05-29 |
| 1962668194 | Howard Warren Kessler | Orthopaedic Surgery | 2390 Phillips Road, Tallahassee, FL 32308-5326 | 2008-08-07 |
| 1962563981 | David Anthony Crumbie Jr. | Orthopaedic Surgery | 4004 Kilmartin Dr, Tallahassee, FL 32309-2853 | 2006-12-13 |
| 1518934694 | Hank Lawrence Hutchinson | Orthopaedic Surgery | 3334 Capital Medical Blvd #400, Tallahassee, FL 32308-4470 | 2006-03-07 |
| 1306848445 | Peter E Loeb | Orthopaedic Surgery | 1911 Miccosukee Rd, Tallahassee, FL 32308-5321 | 2005-08-10 |
| 1619970589 | David Christian Berg | Orthopaedic Surgery | 3334 Capital Medical Blvd, Ste. 400, Tallahassee, FL 32308-8405 | 2005-05-24 |
| 1073516837 | Thomas C Haney | Orthopaedic Surgery | 3334 Capital Medical Blvd Ste 400, Tallahassee, FL 32308-4470 | 2005-05-24 |
| 1255685046 | Ryan Christopher Price | Orthopaedic Surgery | 1401 Centerville Rd Ste 710, Tallahassee, FL 32308 | 2012-11-01 |
| 1962763565 | Chesley F Durgin IIi | Orthopaedic Surgery | 3334 Capital Medical Blvd Ste 400, Tallahassee, FL 32308 | 2012-05-31 |
| 1548588072 | Tony Labree Bryant Jr. | Orthopaedic Surgery | 3334 Capital Medical Blvd Ste 400, Tallahassee, FL 32308-4470 | 2010-05-07 |
| Find all providers in TALLAHASSEE | ||||
| City | TALLAHASSEE |
| Zip Code | 32308 |
Please comment or provide details below to improve the information on DR. EDWARD ROBERT JACKSON II.
| 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.