Jackson, Andrew Thomas

Jackson, Andrew Thomas is an individual health care provider with primary practice located at 210 E Derenne Ave , Savannah GA 31405-6736. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Orthopaedic Surgery, Allopathic & Osteopathic Physicians / General Practice. Allopathic & Osteopathic Physicians / Orthopaedic Surgery is his primary health care specialty. Jackson, Andrew Thomas can be contacted via phone (912) 644-5300.

Contact Information

Primary practice address
210 E Derenne Ave Savannah GA 31405-6736
Phone: (912) 644-5300
Fax: (912) 644-5241
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Orthopaedic Surgery 207X00000X 52399 South Carolina
Allopathic & Osteopathic Physicians / Orthopaedic Surgery 207X00000X 081265 Georgia
Allopathic & Osteopathic Physicians / General Practice 208D00000X 28038 Nebraska

Profile Details

NPI number 1093056988
LBN Legal business name Jackson, Andrew Thomas
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 3rd, 2013
Last updated Oct 24th, 2019 - about 6 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1093056988 NPPES
Georgia MEDICAID 003209886A
Georgia MEDICAID 523990

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