National Provider Identifier
Dewey Thomas Jackson, MD
Dewey Thomas Jackson, MD is listed in the NPPES registry with a primary specialty of Internal Medicine Physician in Fairport, NY and a listed phone number of (585) 248-9670.
Profile Overview
- NPI
- 1659330108
- Provider Type
- Individual
- Primary Specialty
- Internal Medicine Physician
- Enumeration Date
- March 22, 2006
- Last Updated
- July 08, 2007
Practice Location
- 2828 Baird RD
- Fairport, NY 14450-1247
Phone: (585) 248-9670
Specialties
- Internal Medicine Physician (207R00000X)
Full Record
- NPI
- 1659330108
- Entity Type
- Individual
- Last Name
- Jackson
- First Name
- Dewey
- Middle Name
- Thomas
- Name Prefix
- Mr.
- Credential
- MD
- Mailing Street Address
- 2828 Baird RD
- Mailing City
- Fairport
- Mailing State
- NY
- Mailing ZIP Code
- 14450-1247
- Mailing Country
- US
- Mailing Phone
- (585) 248-9670
- Mailing Fax
- (585) 248-0384
- Practice Street Address
- 2828 Baird RD
- Practice City
- Fairport
- Practice State
- NY
- Practice ZIP Code
- 14450-1247
- Practice Country
- US
- Practice Phone
- (585) 248-9670
- Practice Fax
- (585) 248-0384
- Enumeration Date
- March 22, 2006
- Last Updated
- July 08, 2007
- Sex
- Male
- Sole Proprietor
- X
- updated_by_file
- npidata_pfile_20050523-20260308.csv
- Taxonomies
- Internal Medicine Physician (207R00000X)
- Other Identifiers
- 100843BJ (NY, Preferred Care), 10162610 (NY, Blue Choice)