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

Dr. Keith Jackson, MD

Individual provider Otolaryngology Physician · NPI 1225016454

Dr. Keith Jackson, MD is an Otolaryngology in Roswell, Georgia. Graduated from Medical College of Georgia School of Medicine in 1983, 43 years ago. Practices with Professional Resources Management of Rabun LLC, a 17-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in Georgia.

Years since qualifying
43
Trained at
Medical College of Georgia School of Medicine
Licensed in
GA
In the registry since
2006
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

1360 Uppr Hembree RD Ste 201B
Roswell, GA 30076-1230
Phone: (770) 475-3361
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 11685 Alpharetta Hwy, Roswell, GA 30076-4913 — (770) 475-3361

Specialties & licences

Otolaryngology Physician (primary) Taxonomy 207Y00000X · Licence 027575 (GA)

Record details

NPI number1225016454
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedJanuary 6, 2006
Last updated in NPPESOctober 15, 2019
Mailing address12080 Wildwood Springs Dr, Roswell, GA 30075-1887

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyOTOLARYNGOLOGY
Medical schoolMEDICAL COLLEGE OF GEORGIA SCHOOL OF MEDICINE
Graduated 1983 (43 years in practice)
Group practice Professional Resources Management Of Rabun Llc — 17 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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