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

Dr. Bethany Wall Jackson, MD

Individual provider Pediatrics Physician · NPI 1033396841

Dr. Bethany Wall Jackson, MD is a Pediatrics Physician in Rome, Georgia. Licensed in Georgia. Registered with an NPI since 2008.

Licensed in
GA
In the registry since
2008
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

2112 Shorter Ave NW Ste 240
Rome, GA 30165-2042
Phone: (706) 368-8575
Fax: (706) 204-9430
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Pediatrics Physician (primary) Taxonomy 208000000X · Licence 060642 (GA)

Record details

NPI number1033396841
Entity typeIndividual (Type 1)
GenderFemale
Credentials MD
Sole proprietorNo
NPI enumeratedJanuary 23, 2008
Last updated in NPPESApril 16, 2024
Certification dateApril 16, 2024
Mailing addressPo Box 12938, C/O Clinic Management, Calhoun, GA 30703

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