Dr David Dewitt Jackson, MD is a medicare enrolled "Surgery" physician in Mt Airy, North Carolina. His current practice location is
708 S South St, Ste 100, Mt Airy, North Carolina. You can reach out to his office (for appointments etc.) via phone at
(336) 789-9176.
Dr David Dewitt Jackson is licensed to practice in North Carolina (license number 18662) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1942206453.
Physician's Profile
| Full Name | Dr David Dewitt Jackson |
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| Gender | Male |
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| Speciality | Surgery |
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| Location | 708 S South St, Mt Airy, North Carolina |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
NPI Data:
- NPI Number: 1942206453
- Provider Enumeration Date: 06/21/2005
- Last Update Date: 10/29/2015
Medicare PECOS Information:
- PECOS PAC ID: 3072638261
- Enrollment ID: I20100910000897
Medical Identifiers
Medical identifiers for Dr David Dewitt Jackson such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
| 1942206453 | NPI | - | NPPES |
| 1912995093 | Other | NC | SURRY SURGICAL GROUP NPI |
| 8945509 | Medicaid | NC | |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
| 208600000X | Surgery | 18662 (North Carolina) | Primary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Dr David Dewitt Jackson allows following entities to bill medicare on his behalf.
| Entity Name | Northern Hospital Of Surry County |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1114467404 PECOS PAC ID: 0244281749 Enrollment ID: O20170911002297 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Dr David Dewitt Jackson is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
Dr David Dewitt Jackson, MD Po Box 1267, Mt Airy, NC 27030-1267 Ph: (336) 786-4522 | Dr David Dewitt Jackson, MD 708 S South St, Ste 100, Mt Airy, NC 27030-4426 Ph: (336) 789-9176 |
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