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Contact Information

REGINALD R JACKSON, MD
35 COLLIER RD NW
SUITE 635
ATLANTA, GA30309
 Phone: 404-367-3014
 Fax: 404-367-3558
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Hospitalist

208M00000X
 

Internal Medicine

207R00000X 11 Physician/Internal Medicine
Indicates primary specialty

NPI Profile & details for REGINALD R JACKSON · (Male)

NPI Number 1154427615
Status Active
Credentials MD
Entity Individual
Enumeration date 09/15/2006
Last updated 05/29/2024 - About 2 years ago
Sole proprietor 1 No
Identifiers
  • GA License # 051007
  • GA Medicaid 00932896A
Hospital affiliation(s)
  • ATLANTA MEDICAL CENTER - (Acute Care)
    303 PARKWAY DR NE
    ATLANTA, GA 30312
  • EMORY UNIVERSITY HOSPITAL MIDTOWN - (Acute Care)
    550 PEACHTREE ST NE
    ATLANTA, GA 30308
  • SOUTHERN REGIONAL MEDICAL CENTER - (Acute Care)
    11 UPPER RIVERDALE ROAD, SW
    RIVERDALE, GA 30274
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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