NPI 1093710089

Timothy D Jackson, MDSAC

Practitioner Surgical Assistant Gulfport, MS

Practice location

Address: 4500 13th St, Gulfport, MS 39501-2515
Phone: (228) 304-9436
Mailing address: 15520 Daniel Blvd # 310, Gulfport, MS 39503-4735

Registered specialties (2)

Surgical Assistant Primary

Technologists, Technicians & Other Technical Service Providers Taxonomy 246ZC0007X Licence 19-516

Other Specialist/Technologist, Other providers in Mississippi →

Orthopaedic Surgery Physician

Allopathic & Osteopathic Physicians Taxonomy 207X00000X Licence 14510 (MS)

Other Orthopaedic Surgery providers in Mississippi →

Registry record

NPI: 1093710089
Entity type: Individual
Sex (as registered): Male
NPI issued: 16 Jun 2005
Record last updated: 14 Jan 2026

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.