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Contact Information

LASANDRA D JACKSON, MD
2755 S HIGHWAY 14
SUITE 2200
GREER, SC29650-4902
 Phone: 864-849-9555
 Fax: 864-849-9556
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Surgery

208600000X 02 Physician/General Surgery
Indicates primary specialty

NPI Profile & details for LASANDRA D JACKSON · (Female)

NPI Number 1356429674
Status Active
Credentials MD
Entity Individual
Enumeration date 11/02/2006
Last updated 01/21/2025 - More than a year ago
Sole proprietor 1 No
Identifiers
  • SC License # 20289
  • VA License # 0101240815
  • SC Medicaid 202890
  • VA Other C06695 GROUP PTAN
  • VA Other C09633 GROUP PTAN
Hospital affiliation(s)
  • CAROLINAS MEDICAL CENTER-LINCOLN - (Acute Care)
    433 MCALISTER RD
    LINCOLNTON, NC 28092
  • HALIFAX REGIONAL MEDICAL CENTER INC - (Acute Care)
    250 SMITH CHURCH RD
    ROANOKE RAPIDS, NC 27870
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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