Gary Dean Jackson, R.PH.

Primary specialty

PharmacistTaxonomy code 183500000X

License

E-06793 Issued in MS

Practice address

11340 Three Rivers Rd Ste a
Gulfport, MS 39503-3650

Phone

(228) 832-8000

Fax

(228) 832-0808

NPI assigned

Sep 17, 2019

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Pharmacist

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Jacksons Discount Pharmacy Inc

  • Community/Retail Pharmacy
  • Gulfport, MS
  • NPI 1326084831
  NPD Authorized official
• Jackson'S Discount Pharmacy, Inc.

  • Specialty Pharmacy
  • Gulfport, MS
  • NPI 1568669208
  NPD

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

{
    "created_epoch": "1568678400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1568678400000",
    "number": "1609426022",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11340 THREE RIVERS RD STE A",
            "city": "GULFPORT",
            "state": "MS",
            "postal_code": "395033650",
            "telephone_number": "228-832-8000",
            "fax_number": "228-832-0808"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11340 THREE RIVERS RD STE A",
            "city": "GULFPORT",
            "state": "MS",
            "postal_code": "395033650",
            "telephone_number": "228-832-8000",
            "fax_number": "228-832-0808"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "GARY",
        "middle_name": "DEAN",
        "name_prefix": "Mr.",
        "credential": "R.PH.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-09-17",
        "last_updated": "2019-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MS",
            "license": "E-06793",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mohammad Awad Jaber, M.D.
• Lakeisha J Jackson-Patton, PHARM.D.
• Aaliyah Jackson
• Avery Jackson, APRN, FNP-C
• Christopher E Jackson
• Janice L. Jackson
• Jennifer Jackson, NP
• Linda Natasha Rene Jackson, LPC
• Lucia Jackson, LOT, CHT
• Melissa M Jackson, LCSW

• Pharmacist in Gulfport, MS
• Providers in Gulfport, MS by specialty
• Pharmacist in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 2019; 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.