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Individual

DR. THOMAS R JACKSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
500 STATE ST, SCHENECTADY, NY 12305-2414
(518) 489-2663
Mailing address
121 EVERETT RD, ALBANY, NY 12205-1474
(518) 489-2663

Taxonomy

Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
2011-00970
NC
208100000X
Physical Medicine & Rehabilitation Physician
MD13171
RI
208100000X
Physical Medicine & Rehabilitation Physician
MT179687
PA
2081P2900X
Pain Medicine (Physical Medicine & Rehabilitation) Physician
MD13171
RI
208VP0014X
Interventional Pain Medicine Physician
Primary
246110
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
04074237
NY
05
1790765667
NC
05
5918134
NC
05
NC1445
SC
05
TJ79199
RI
Enumeration date
01/18/2006
Last updated
07/17/2025
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