DR. TIM JACKSON
NPI 1003958117
Specialist in Gulfport, MS

Q: What is Moriah's NPI number?

The NPI number for Moriah is 1003958117. It was assigned to this organization in the NPPES registry on February 13, 2007. The provider is doing business as Dr. Tim Jackson.

Q: What is Moriah's specialty?

The primary specialty registered for this NPI is Specialist with taxonomy code 174400000X.

Q: When was this NPI record last updated?

The NPPES record for Moriah was last updated on August 22, 2008. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 17 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since February 13, 2007

12080 NEW ORLEANS AVE N, GULFPORT, MS 39503(228) 832-9933(228) 832-9916 Get Directions Write a Review

NPPES record last updated: August 22, 2008. Verified against the NPPES registry weekly; last sync: August 02, 2026.

On this page

About Dr. Tim Jackson NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. TIM JACKSON (NPI 1003958117) is a healthcare organization registered as a specialist in Gulfport, Mississippi and active in the NPI registry since February 2007. The organization lists Timothy D Jackson, Owner, as its authorized official.

NPPES Registry Identity

NPI1003958117

Entity TypeOrganization

Primary Taxonomy174400000X

Legal Business NameMORIAH

Location Address12080 NEW ORLEANS AVE NGulfport, MS 39503-3180

Mailing AddressPo Box 10049Gulfport, MS 39505-0049 · (228) 832-9933 · Fax (228) 832-9916

Phone(228) 832-9933

Fax(228) 832-9916

Organization SubpartNo

Authorized OfficialTimothy D JacksonOwner · (228) 832-9933

Enumeration DateFebruary 13, 2007

Last NPPES UpdateAugust 22, 2008

✔ NPI 1003958117 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySpecialistOther Service Providers

Taxonomy Code174400000X

License✔ Licensed in MS · 14510

Definition

An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.

12080 NEW ORLEANS AVE N, Gulfport, MS 39503

Open in Google Maps ↗

Other Names 1

Doing Business AsDr. Tim Jackson

Other Identifiers 4

Medicare NSC4462430001MS

Medicare UPING11631MS

Medicare ID-Type Unspecified200000378MS

Medicaid00124986MS

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Moriah's NPI number?

The NPI number for Moriah is 1003958117. It was assigned to this organization in the NPPES registry on February 13, 2007. The provider is doing business as Dr. Tim Jackson.

Where is Moriah located?

Moriah is located at 12080 New Orleans Ave N, Gulfport, MS 39503. The listed phone number is (228) 832-9933.

What is Moriah's specialty?

The primary specialty registered for this NPI is Specialist with taxonomy code 174400000X.

When was this NPI record last updated?

The NPPES record for Moriah was last updated on August 22, 2008. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 17 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.