National Provider Identifier Database

THEODORE A JACKSON, MD – NPI #1942294376
Plastic Surgery

A plastic surgeon deals with the repair, reconstruction or replacement of physical defects of form or function involving the skin, musculoskeletal system, craniomaxillofacial structures, hand, extremities, breast and trunk and external genitalia or cosmetic enhancement of these areas of the body. Cosmetic surgery is an essential component of plastic surgery. The plastic surgeon uses cosmetic surgical principles to both improve overall appearance and to optimize the outcome of reconstructive procedures. The surgeon uses aesthetic surgical principles not only to improve undesirable qualities of normal structures but in all reconstructive procedures as well.


Contact Information

THEODORE A JACKSON, MD
1306 KANAWHA BLVD E
SUITE 100
CHARLESTON, WV25301-3001
Phone: 304-342-1113
Fax: 304-346-2271
Website:
Specialty Taxonomy Code
* Plastic Surgery 208200000X
Surgery of the Hand 2082S0105X

* Indicates primary specialty

NPI Profile & details for THEODORE A JACKSON

NPI Number 1942294376
Credentials MD
Entity Individual
Enumeration date 08/31/2005
Last updated 03/12/2009 - About 17 years ago
Sole proprietor1 No
Identifiers
  • WV License #: 13531
  • WV Medicaid: 0051155000
Hospital affiliation n/a

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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