DANIEL FORREST JACKSON III (NPI# 1922052794) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1922052794 |
| Entity Type | Individual |
| Full Name | DANIEL FORREST JACKSON III |
| Credential | MD |
| Practice Address |
480 Honeysuckle Rd Dothan AL 36305 |
| Practice Telephone | 3348361212 |
| Practice Fax Number | 3348361888 |
| Mailing Telephone | 3348361212 |
| Mailing Fax Number | 3348361888 |
| Enumeration Date | 2006-05-19 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RG0100X |
Internal Medicine Specialization: Gastroenterology |
11900 | AL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| GA | 00301254A | 05 | |
| RAILROAD MEDICARE | P00229127 | 01 | |
| UNITED HEALTHCARE | 1199413 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780043091 | Daniel Jackson | Occupational Therapy Assistant | 2906 Weatherstone Dr, Kirksville, MO 63501-5658 | 2016-02-15 |
| 1124342803 | Daniel Jackson | Dentist | 821 W Pine St, Poplar Bluff, MO 63901-4956 | 2010-03-24 |
| 1649354200 | Daniel Dewey Jackson | Dentist | 277 5th Street, Ashland, OR 97520 | 2006-10-24 |
| 1225042609 | Daniel Wayne Jackson Jr. | Psychologist | 1500 Norwood Dr, #205, Hurst, TX 76054-3651 | 2006-07-28 |
| 1972502391 | Daniel Mark Jackson | Optometrist | 713 N 114th St, Omaha, NE 68154-1515 | 2005-07-18 |
| 1639795776 | Daniel L Jackson | Occupational Therapist | 4015 Lake Otis Pkwy Ste 200, Anchorage, AK 99508-5235 | 2020-06-24 |
| 1902369549 | Daniel Brett Jackson | Student in an Organized Health Care Education/Training Program | 3690 Grandview Parkway, Pathology Department, Birmingham, AL 35243 | 2019-04-10 |
| 1366975989 | Daniel Jackson | Student in an Organized Health Care Education/Training Program | 750 E Adams St, Syracuse, NY 13210 | 2017-04-10 |
| 1689028516 | Daniel Jackson | Emergency Medicine | 5323 Harry Hines Blvd, Dallas, TX 75390-7201 | 2016-04-18 |
| 1750773388 | Daniel Jackson | Case Manager/Care Coordinator | 81557 Dr Carreon Blvd Ste C9, Indio, CA 92201-5562 | 2015-02-18 |
| Street Address |
480 HONEYSUCKLE RD |
| City | DOTHAN |
| State | AL |
| Zip Code | 36305 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518922087 | Travis J Rutland | Internal Medicine | 480 Honeysuckle Rd, Dothan, AL 36305-1156 | 2006-04-19 |
| 1992202741 | Laboratory Corportation of America Holdings | Clinical Medical Laboratory | 480 Honeysuckle Rd, Dothan, AL 36305-1156 | 2018-04-09 |
| 1679941884 | Breeann Gilmore | Nurse Practitioner | 480 Honeysuckle Rd, Dothan, AL 36305-1156 | 2015-09-03 |
| 1992055883 | Nicholas Cody Mendheim | Nurse Practitioner | 480 Honeysuckle Rd, Dothan, AL 36305-1156 | 2012-09-18 |
| 1679835532 | Laboratory Corporation of America Holdings | Clinical Medical Laboratory | 480 Honeysuckle Rd, Dothan, AL 36305-1156 | 2012-06-15 |
| 1689932022 | Gypsy Rain Glover | Nurse Practitioner | 480 Honeysuckle Rd, Dothan, AL 36305-1156 | 2012-04-23 |
| 1720352818 | Susan Elaine Broyles | Nurse Practitioner | 480 Honeysuckle Rd, Dothan, AL 36305-1156 | 2012-03-07 |
| 1790075950 | George Augustus Nelson Iv | Internal Medicine | 480 Honeysuckle Rd, Dothan, AL 36305-1156 | 2011-04-08 |
| 1396044426 | Amy Cole Ethridge | Nurse Practitioner | 480 Honeysuckle Rd, Dothan, AL 36305-1156 | 2011-03-15 |
| 1588981872 | Scott Andrew Sarrels | Internal Medicine | 480 Honeysuckle Rd, Dothan, AL 36305-1156 | 2010-04-26 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962059998 | Samantha Nicole Bolden | Counselor | 1001 John D. Odom Road, Dothan, AL 36305 | 2019-08-23 |
| 1578968780 | Aba Therapy & Consulting Services | Behavioral Analyst | 3124 West Main Street, Suite 9, Dothan, AL 36305 | 2014-10-30 |
| 1306247796 | Tracey Lynn Carter | Registered Nurse | 4300 W Main St Ste 102, Dothan, AL 36305 | 2014-09-04 |
| 1760829881 | Michael Brent Nance | Nurse Practitioner | 4370 West Main Street, Dothan, AL 36305 | 2013-05-30 |
| 1033495221 | Professional Resource Management of Wiregrass, LLC | Psychiatry & Neurology | 2812 Hartford Hwy Ste 1, Dothan, AL 36305 | 2011-11-01 |
| 1649555483 | Ashley Dawn Morrow | Pharmacist | 2940 West Main Street, Dothan, AL 36305 | 2011-10-12 |
| 1740599273 | Aline M Mays-easley | Counselor | 309 Ameris Ave, Dothan, AL 36305 | 2010-10-01 |
| 1356671408 | Kimberly Jones Rogers | Clinical Neuropsychologist | 200 Grove Park Ln Ste 212, Dothan, AL 36305 | 2010-01-12 |
| 1639347818 | Southeast Alabama Counseling & Behavioral Specialist | Residential Treatment Facility, Emotionally Disturbed Children | 407 Honeysuckle Rd Ste 207, Dothan, AL 36305 | 2008-02-11 |
| 1770705667 | Michala Long | Pharmacist | 3850 West Main St, Dothan, AL 36305 | 2007-05-02 |
| Find all providers in zip 36305 | ||||
| Taxonomy Code | 207RG0100X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Gastroenterology |
| An internist who specializes in diagnosis and treatment of diseases of the digestive organs including the stomach, bowels, liver and gallbladder. This specialist treats conditions such as abdominal pain, ulcers, diarrhea, cancer and jaundice and performs complex diagnostic and therapeutic procedures using endoscopes to visualize internal organs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518922087 | Travis J Rutland | Internal Medicine | 480 Honeysuckle Rd, Dothan, AL 36305-1156 | 2006-04-19 |
| 1790075950 | George Augustus Nelson Iv | Internal Medicine | 480 Honeysuckle Rd, Dothan, AL 36305-1156 | 2011-04-08 |
| 1386769404 | Paul Brandon Lamb | Internal Medicine | 480 Honeysuckle Rd, Dothan, AL 36305-1156 | 2007-03-20 |
| 1407913437 | Gastroenterology Associates of Dothan, PC | Internal Medicine | 480 Honeysuckle Rd, Dothan, AL 36305-1156 | 2007-01-02 |
| 1730126913 | Stavros A Diavolitsis | Internal Medicine | 480 Honeysuckle Rd, Dothan, AL 36305-1156 | 2006-05-31 |
| 1043264336 | Jeffrey John Crittenden | Internal Medicine | 480 Honeysuckle Rd, Dothan, AL 36305-1156 | 2006-05-20 |
| 1073566006 | Gut PC | Internal Medicine | 480 Honeysuckle Rd, Dothan, AL 36305 | 2006-05-19 |
| 1104870971 | William Davis Mclaughlin | Internal Medicine | 480 Honeysuckle Rd, Dothan, AL 36305 | 2006-05-19 |
| 1225081177 | Robert Philip Albares | Internal Medicine | 480 Honeysuckle Rd, Dothan, AL 36305-1156 | 2006-05-19 |
| 1225080906 | Samuel Joseph Tarwater | Internal Medicine | 480 Honeysuckle Rd, Dothan, AL 36305 | 2006-05-17 |
| Find all providers in DOTHAN | ||||
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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.