Physician Compare National (NPI:1598744542)

HEALTHCARE PROVIDER: OSCAR D. JACKSON JR. M.D.

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information
NPI	1598744542
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	2860684180
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20101006000040
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	JACKSON
	Individual professional last name
Provider First Name	OSCAR
	Individual professional first name
Provider Middle Name	DUNWODY
	Individual professional middle name
Provider Name Suffix Text	JR.
	The name suffix of the provider if the provider is an individual. The name suffix is a ''generation-related'' suffix, such as Jr., Sr., II, III, IV, or V.
Provider Gender	M
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	MEDICAL COLLEGE OF GEORGIA SCHOOL OF MEDICINE
	Individual professional's medical school
Graduation Year	1984
	Individual professional's medical school graduation year
Primary Specialty	OBSTETRICS/GYNECOLOGY
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Line 1 Street Address	805 S HANSELL ST
	Group Practice or individual's line 1 address
City	THOMASVILLE
	Group Practice or individual's city
State	GA
	Group Practice or individual's state
Zip Code	317925560
	Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information
Hospital Affiliation CCN 1	110038
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	JOHN D ARCHBOLD MEMORIAL HOSPITAL
	Legal business name of hospital where individual professional provides service 1
Professional Accepts Medicare Assignment	Y