Dena W. Jackson, M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

DENA W. JACKSON, M.D.

Practice address

527 Silver Cross Dr
Brookhaven, MS 39601-2388

Phone

(601) 835-0507

Fax

(601) 835-2766

NPI assigned

Aug 30, 2006

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Diane M Price

Title

Office Manager

Phone

(601) 835-0507

Specialties & licenses 1

Addresses

Other identifiers 1

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1427168368",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4197",
            "city": "BROOKHAVEN",
            "state": "MS",
            "postal_code": "396036197",
            "telephone_number": "601-835-0507",
            "fax_number": "601-835-2766"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "527 SILVER CROSS DR",
            "city": "BROOKHAVEN",
            "state": "MS",
            "postal_code": "396012388",
            "telephone_number": "601-835-0507",
            "fax_number": "601-835-2766"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DENA W. JACKSON, M.D.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-30",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "PRICE",
        "authorized_official_first_name": "DIANE",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "601-835-0507"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "09015702",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• George Crouse, FNP-BC
• Timothy Charles Cunningham, PT
• Bruce Currie, PT
• Melissa J Davis, FNP-C
• Natalie Davis
• Courtney L Denton, LMFT
• DHP Brookhaven, Inc
• Erica Jana Diggs
• Dignity Hospice LLC
• Edward Dillon Sr.

• Internal Medicine Physician in Brookhaven, MS
• Providers in Brookhaven, MS by specialty
• Internal Medicine Physician in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.