Individual
DR. JACKSON SCOTT THOMAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2124 14TH ST, MERIDIAN, MS 39301-4040
(601) 553-6000
(601) 703-0124
Mailing address
965 RIDGE LAKE BLVD STE 315, MEMPHIS, TN 38120-9401
(877) 348-1281
(901) 227-3206
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
15444
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00119589
—
MS
01
—
MS15444
MS LICENSE NUMBER
MS
Enumeration date
09/20/2006
Last updated
01/13/2025
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