Individual provider · Type 1 NPI

Theodore A. Jackson, MD

Plastic Surgery Physician · Charleston, WV

NPI number 1942294376 Active

Practice location

1306 Kanawha Blvd E, Suite 100
Charleston, WV 25301-3001

Call (304) 342-1113 Map

Fax (304) 346-2271

Specialties and licenses

TaxonomyCodeLicense
Plastic Surgery Physician Primary 208200000X13531 (WV)
Surgery of the Hand (Plastic Surgery) Physician 2082S0105X13531 (WV)

Plastic Surgery Physician: A plastic surgeon deals with the repair, reconstruction or replacement of physical defects of form or function involving the skin, musculoskeletal system, craniomaxillofacial structures, hand, extremities, breast and trunk and external genitalia or cosmetic enhancement of these areas of the body. Cosmetic surgery is an essential component of plastic surgery. The plastic surgeon uses cosmetic surgical principles to b…

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About NPI 1942294376

Theodore A. Jackson, MD's National Provider Identifier is 1942294376, issued on Aug 31, 2005. The primary taxonomy on file is Plastic Surgery Physician (208200000X), and the practice location is in Charleston, WV. The record was last updated on Mar 12, 2009.