Individual
DR. TIMOTHY D JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD, SA-C
Contact information
Practice address
4500 13TH ST, GULFPORT, MS 39501-2515
(228) 304-9436
Mailing address
15520 DANIEL BLVD # 310, GULFPORT, MS 39503-4735
(228) 304-9436
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
14510
MS
246ZC0007X
Surgical Assistant
Primary
19-516
—
Other
Enumeration date
06/16/2005
Last updated
01/14/2026
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