Individual
DR. THOMAS R JACKSON
Active
Individual
DR. THOMAS R JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
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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