W Jackson Iliff M.D., LLC

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

License

D08485 Issued in MD

Legal business name

W JACKSON ILIFF M.D., LLC

Practice address

4 W Rolling Crossroads
Ste 7
Catonsville, MD 21228-6280

Phone

(410) 869-1990

NPI assigned

Nov 12, 2009

Organization subpart

No

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

Authorized official

Name

W Jackson Iliff, M.D.NPI 1902866379

Title

Owner

Phone

(410) 869-1990

Specialties & licenses 1

Addresses

Other identifiers 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• W. Jackson Iliff, M.D.

  • Ophthalmology Physician
  • Catonsville, MD
  • NPI 1902866379
  Authorized official Same address or phone

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

{
    "created_epoch": "1257984000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1257984000000",
    "number": "1962739839",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4 W ROLLING CROSSROADS",
            "address_2": "STE 7",
            "city": "CATONSVILLE",
            "state": "MD",
            "postal_code": "212286280",
            "telephone_number": "410-869-1990"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4 W ROLLING CROSSROADS",
            "address_2": "STE 7",
            "city": "CATONSVILLE",
            "state": "MD",
            "postal_code": "212286280",
            "telephone_number": "410-869-1990"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "W JACKSON ILIFF M.D., LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-11-12",
        "last_updated": "2009-11-12",
        "status": "A",
        "authorized_official_last_name": "ILIFF",
        "authorized_official_first_name": "W",
        "authorized_official_middle_name": "JACKSON",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "410-869-1990",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Ophthalmology",
            "state": "MD",
            "license": "D08485",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "964451200",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Ophthalmology Physician in Catonsville, MD
• Providers in Catonsville, MD by specialty
• Ophthalmology Physician in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 2009; 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.