Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Dr. Theodore A. Jackson, MD

Individual provider Plastic Surgery Physician · NPI 1942294376

Dr. Theodore A. Jackson, MD is a Plastic Surgery Physician in Charleston, West Virginia. Licensed in West Virginia. Registered with an NPI since 2005.

Licensed in
WV
In the registry since
2005
Specialties on file
2
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

1306 Kanawha Blvd E Ste 100
Charleston, WV 25301-3001
Phone: (304) 342-1113
Fax: (304) 346-2271
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Plastic Surgery Physician (primary) Taxonomy 208200000X · Licence 13531 (WV)
Surgery of the Hand (Plastic Surgery) Physician Taxonomy 2082S0105X · Licence 13531 (WV)

Record details

NPI number1942294376
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedAugust 31, 2005
Last updated in NPPESMarch 12, 2009

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