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

Timothy Jacks, DO

Individual provider Pediatrics Physician · NPI 1164686549

Timothy Jacks, DO is a Pediatrics Physician in Mesa, Arizona. Licensed in Arizona. Registered with an NPI since 2008.

Licensed in
AZ
In the registry since
2008
What do these letters mean?
DO — Doctor of Osteopathic Medicine
A fully licensed physician, trained like an MD with additional musculoskeletal training. Equivalent practice rights in all 50 states.

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Practice location Address checks out

4540 E Baseline Rd Ste 108
Mesa, AZ 85206-4613
Phone: (480) 892-3880
Fax: (480) 545-4551
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Pediatrics Physician (primary) Taxonomy 208000000X · Licence R70095 (AZ)

Record details

NPI number1164686549
Entity typeIndividual (Type 1)
GenderMale
Credentials DO
Sole proprietorNo
NPI enumeratedJuly 15, 2008
Last updated in NPPESMay 17, 2013
Mailing address4540 E Baseline Rd, Suite 108, Mesa, AZ 85206-4613

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