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Contact Information

TIMOTHY M JACKSON, DMD
982 DRAYTON AVENUE
ELBA, AL36323
 Phone: 334-897-3418
 Fax: 334-897-3438
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Dentist

122300000X
Indicates primary specialty

NPI Profile & details for TIMOTHY M JACKSON · (Male)

NPI Number 1972610947
Status Active
Credentials DMD (Doctor of Medical Dentistry)
Entity Individual
Enumeration date 08/24/2006
Last updated 07/08/2007 - About 19 years ago
Sole proprietor 1 No
Identifiers
  • AL License # 4025
Hospital affiliation(s) Not Available
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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