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Contact Information

ANDREW T JACKSON, MD
210 E DERENNE AVE
SAVANNAH, GA31405-6736
 Phone: 912-644-5300
 Fax: 912-644-5241
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Orthopaedic Surgery

207X00000X 02 Physician/General Surgery
 

General Practice

208D00000X 99 Physician/Undefined Physician type[6]
Indicates primary specialty

NPI Profile & details for ANDREW T JACKSON · (Male)

NPI # 1093056988
Status Active
Credentials MD
Entity Individual
Enumeration date 03/03/2013
Last updated 10/24/2019 - About 7 years ago
Sole proprietor 1 No
Identifiers
  • GA License # 081265
  • NE License # 28038
  • SC License # 52399
  • GA Medicaid 003209886A
  • SC Medicaid 523990
Hospital affiliation(s)
  • EAST GEORGIA REGIONAL MEDICAL CENTER - (Acute Care)
    1499 FAIR ROAD
    STATESBORO, GA 30458
  • SOUTH GEORGIA MEDICAL CENTER - (Acute Care)
    2501 NORTH PATTERSON STREET, PO BOX 1727
    VALDOSTA, GA 31603
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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