Dr. Bethany Wall Jackson
M.D. | Pediatrics | Female
Dr. Bethany Wall Jackson, M.D. is a Rome, Georgia based Pediatric doctor with medical specialization in
General Pediatrics. Dr. Bethany Wall Jackson is also known as
Bethany Jean Wall.
Current practice location of Dr. Bethany Wall Jackson is
304 Shorter Ave Nw Ste 105, Rome, Georgia - 30165-4256. She can be contacted on phone at
706-291-4880.
Dr. Bethany Wall Jackson is a sole proprietor of her business.
NPI number (Unique professional ID) for Dr. Bethany Wall Jackson is
1033396841 which was assigned by NPPES on 23 Jan, 2008 and it was last updated on 10 Mar, 2023.
Dr. Bethany Wall Jackson license number is
060642 for Pediatrics (208000000X) in Georgia.
Dr. Bethany Wall Jackson is a pediatrician who is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.
Complete Profile:
Dr. Bethany Wall Jackson basic information including her official name, gender, specialization, credentials etc. are as mentioned below.
| Specialization : | Pediatrics |
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| Provider Name : | Dr. Bethany Wall Jackson |
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| Other Name : | Bethany Jean Wall |
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| Credential : | M.D. |
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| Gender : | Female |
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Business Address:
Dr. Bethany Wall Jackson address, contact phone number and fax are as below. Patients can directly walkin to the clinic or can call on the below given phone number for appointment.
| Primary Address : | 304 Shorter Ave Nw Ste 105
Rome, GA, 30165-4256
United States |
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| Phone Number : | 706-291-4880 |
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Professional Identification Codes:
NPI number stands for National Provider Identifier which is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS). NPI details are as mentioned below.
| NPI Number : | 1033396841 |
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| NPI Entity Type : | Individual |
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| First Enrolment Date : | 23 Jan, 2008 |
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| Last Updated On : | 10 Mar, 2023 |
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Licenses and Specialities:
Physicians/Organizations can have one or more medical licenses for different specialities in the same state or different states. Related medical licenses for Dr. Bethany Wall Jackson are as mentioned. Primary taxonomy code for Dr. Bethany Wall Jackson, M.D. is
208000000X (Pediatrics).
| Taxonomy Code | Speciality | Primary | License No. | State |
|---|
| 208000000X | Pediatrics | Yes | 060642 | GA |
Legacy Identifiers:
Other legacy medical identifiers of Dr. Bethany Wall Jackson such as Medicaid, Medicare PIN, NSC, UPIN etc. are mentioned below.
| Identifier | Identifier Type | State | Issuer |
|---|
| 003132526A | MEDICAID | GA | |
| 003132526B | MEDICAID | GA | |
| 146978 | MEDICAID | AL | |
| 202i378166 | MEDICARE PIN | GA | |
Other Practice Locations:
| Practice Address | City, State | Phone Number |
|---|
330 TURNER MCCALL BLVD SW, SUITE 205
ROME, GA, 30165-5630
United States | ROME, GA | 706-234-2324 |
Endpoints:
Endpoints provide a simple, secure, scalable, and standards-based way for participants to send authenticated, encrypted health information directly to known, trusted recipients over the Internet. It is used by EHR systems (Electronic Health Records).
| Endpoint Type | Endpoint | Affiliation | Use | Content | Address |
|---|
DIRECT
(Direct Messaging Address) | bjackson296508@CarolinasHealthcareSystem.direct-ci.com
| No affiliation |
|
| 330 Turner McCall Blvd SW, Suite 205
Rome, GA, 30165-5630
United States |
Mailing Address:
Mailing address can be used for mailing purpose only, for visiting purpose patients need to refer above mentioned business address only.
| Mailing Address : | 420 E 2nd Ave Ste 103
Rome, GA, 30161-3210
United States |
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| Phone Number : | 706-509-3000 |
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Business Location:
Patients can refer following map for directions to
Dr. Bethany Wall Jackson practice address. Don't forget to take prior appointment before visiting.
** Data of this site is collected from Medicare & Medicaid Services (CMS) and NPPES. Last updated on 08 January, 2024.