DERMATOLOGY CLINIC OF JACKSON
NPI 1073825659
Dermatology in Jackson, TN

Active since July 12, 2010CLIA 44D2058800 · Microscopy
1320 UNION UNIVERSITY DR, JACKSON, TN 38305(731) 422-7999(731) 422-4937 Get Directions Write a Review

NPPES record last updated: July 16, 2014. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Dermatology Clinic Of Jackson NPPES

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

DERMATOLOGY CLINIC OF JACKSON (NPI 1073825659) is a healthcare organization registered as a dermatology in Jackson, Tennessee and active in the NPI registry since July 2010. The organization holds a CLIA Microscopy certificate valid through May 12, 2027 and lists William Patrick Teer, President, as its authorized official.

NPPES Registry Identity

NPI1073825659
Entity TypeOrganization
Primary Taxonomy207N00000X
Legal Business NameDERMATOLOGY CLINIC OF JACKSON
Location Address1320 UNION UNIVERSITY DRJackson, TN 38305-3780
Mailing Address1320 Union University DrJackson, TN 38305-3780 · (731) 422-7999 · Fax (731) 422-4937
Fax(731) 422-4937
Organization SubpartNo
Authorized OfficialWilliam Patrick TeerPresident · (731) 424-1001
Enumeration DateJuly 12, 2010
Last NPPES UpdateJuly 16, 2014
NPI 1073825659 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyDermatologyAllopathic & Osteopathic Physicians
Taxonomy Code207N00000X
License Licensed in TN · 26042
Definition

A dermatologist is trained to diagnose and treat pediatric and adult patients with benign and malignant disorders of the skin, mouth, external genitalia, hair and nails, as well as a number of sexually transmitted diseases. The dermatologist has had additional training and experience in the diagnosis and treatment of skin cancers, melanomas, moles and other tumors of the skin, the management of contact dermatitis and other allergic and nonallergic skin disorders, and in the recognition of the skin manifestations of systemic (including internal malignancy) and infectious diseases. Dermatologists have special training in dermatopathology and in the surgical techniques used in dermatology. They also have expertise in the management of cosmetic disorders of the skin such as hair loss and scars and the skin changes associated with aging.

1320 UNION UNIVERSITY DR, Jackson, TN 38305

Other Identifiers 2

Medicare PIN103G707802TN
Medicaid1521783TN

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

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate for Provider-Performed Microscopy Procedures (PPMP) 44D2058800

Dermatology Clinic Of Jackson · Jackson, TN
Active · expires May 12, 2027
CLIA Number44D2058800
Laboratory TypePhysician Office
Certificate Effective DateMay 13, 2025
Certificate Expiration DateMay 12, 2027
Laboratory DirectorDr. William P. Teer
Laboratory Phone(731) 422-7920
Laboratory LocationDermatology Clinic Of Jackson1320 Union University Dr, Jackson, TN 38305
CLIA data matches this NPI record on: Address Name
This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.

Other Providers at the Same Location NPPES 4

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Dermatology
1320 UNION UNIVERSITY DR
JACKSON, TN 38305
Dermatology
1320 UNION UNIVERSITY DR
JACKSON, TN 38305
Nurse Practitioner (Family)
1320 UNION UNIVERSITY DR
JACKSON, TN 38305
Student in an Organized Health Care Education/Training Program
1320 UNION UNIVERSITY DR
JACKSON, TN 38305

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 Dermatology Clinic Of Jackson's NPI number?

The NPI number for Dermatology Clinic Of Jackson is 1073825659. It was assigned to this organization in the NPPES registry on July 12, 2010.

Where is Dermatology Clinic Of Jackson located?

Dermatology Clinic Of Jackson is located at 1320 Union University Dr, Jackson, TN 38305. The listed phone number is (731) 422-7999.

What is Dermatology Clinic Of Jackson's specialty?

The primary specialty registered for this NPI is Dermatology with taxonomy code 207N00000X.

Does Dermatology Clinic Of Jackson hold a CLIA laboratory certificate?

Yes. A Certificate for Provider-Performed Microscopy Procedures (PPMP) (number 44D2058800) is associated with this NPI, valid through May 12, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Dermatology Clinic Of Jackson was last updated on July 16, 2014. NPI Profile syncs with the weekly NPPES data releases published by CMS.