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General NPI Number Information
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NPI Number | 1407916471
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Entity Type | Organization
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Legal Business Name | THOMASVILLE OBSTETRICS AND GYNECOLOGY, P.C.
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Dates
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Enumeration Date | 12/11/2006
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 805 S HANSELL ST
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City | THOMASVILLE
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State | GA
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Zip | 31792-5560
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Country | US
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Telephone | 229-225-1357
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Fax | 229-225-9935
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Provider Business Mailing Address
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Address Line | 805 S HANSELL ST
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City | THOMASVILLE
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State | GA
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Zip | 31792-5560
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Country | US
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Telephone | 229-225-1357
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Fax | 229-225-9935
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Authorized Official
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Title or Position | OWNER
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Name | DR. OSCAR DUNWODY JACKSON JR.
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Credential | M.D.
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Telephone | 229-225-1357
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | 030793
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 367A00000X
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Taxonomy Name | Advanced Practice Midwife
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License Number | RN159084
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License Number State | GA
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Taxonomy #3
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | 046464
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License Number State | GA
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