EDWARD C JACKMAN (NPI# 1669733580) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1669733580 |
| Entity Type | Individual |
| Full Name | EDWARD C JACKMAN |
| Credential | M.D. |
| Practice Address |
269 S Candy Ln Cottonwood AZ 86326-4158 |
| Mailing Address |
1200 N Beaver St Flagstaff AZ 86001-3118 |
| Practice Telephone | 9286396172 |
| Mailing Telephone | 9282136235 |
| Mailing Fax Number | 9282136292 |
| Enumeration Date | 2012-06-07 |
| Last Update Date | 2020-09-10 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207PE0005X |
Emergency Medicine Specialization: Undersea and Hyperbaric Medicine |
58317 | AZ | Allopathic & Osteopathic Physicians |
| N | 207Q00000X | Family Medicine | 252803 | MA | Allopathic & Osteopathic Physicians |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 275 Nichols Rd, Fitchburg, MA 014201919 | 9788788374 |
| Street Address |
269 S CANDY LN |
| City | COTTONWOOD |
| State | AZ |
| Zip Code | 86326-4158 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356345383 | Eugene M.r. Charlebois | Emergency Medicine | 269 S Candy Ln, Cottonwood, AZ 86326-4158 | 2005-06-08 |
| 1306463740 | Riley Benjamin Johnson | Dietitian, Registered | 269 S Candy Ln, Cottonwood, AZ 86326-4158 | 2020-07-01 |
| 1821619891 | Joshua Thomas Haywood | Student in an Organized Health Care Education/Training Program | 269 S Candy Ln, Cottonwood, AZ 86326-4158 | 2020-04-30 |
| 1396364162 | Jeremy Schmoyer | Student in an Organized Health Care Education/Training Program | 269 S Candy Ln, Cottonwood, AZ 86326-4158 | 2020-04-13 |
| 1144849993 | Miranda Rose Anderson | Student in an Organized Health Care Education/Training Program | 269 S Candy Ln, Cottonwood, AZ 86326-4158 | 2020-04-12 |
| 1659900876 | Eddie Khav | Student in an Organized Health Care Education/Training Program | 269 S Candy Ln, Cottonwood, AZ 86326-4170 | 2020-04-08 |
| 1790314961 | Michelle Anne Pope | Student in an Organized Health Care Education/Training Program | 269 S Candy Ln, Cottonwood, AZ 86326-4158 | 2020-04-08 |
| 1699320390 | Emily Kathryn Danca | Dietitian, Registered | 269 S Candy Ln, Cottonwood, AZ 86326-4158 | 2019-08-08 |
| 1760036909 | Tarra Denise Young | Nurse Practitioner | 269 S Candy Ln, Cottonwood, AZ 86326-4158 | 2019-07-25 |
| 1275195950 | Samer Saeed Hasson | Student in an Organized Health Care Education/Training Program | 269 S Candy Ln, Cottonwood, AZ 86326-4158 | 2019-07-02 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679954895 | Isabelle Maisse Griffith | Pharmacist | 1100 E Highway 89a, Cottonwood, AZ 86326 | 2015-06-12 |
| 1184982266 | Northern Arizona Healthcare Provider Group, LLC | Family Medicine | 450 South Willard Street, Cottonwood, AZ 86326 | 2012-04-26 |
| 1922391663 | Ronald D. Carsrud | Hearing Instrument Specialist | 657 E Cottonwood St., Ste 6c, Cottonwood, AZ 86326 | 2011-05-26 |
| 1760712749 | Chuck Thomas Calvano | Pharmacist | 550 S Main, Cottonwood, AZ 86326 | 2010-01-13 |
| 1528231438 | Elizabeth Lightner Mccarrell | Emergency Medicine | 269 S Candy Lane, Cottonwood, AZ 86326 | 2008-04-11 |
| 1972783355 | The Wick Home for Emotional Growth and Recovery | Residential Treatment Facility, Emotionally Disturbed Children | 2102 E Fir St, Cottonwood, AZ 86326 | 2007-11-14 |
| 1750560165 | David T Sayle | Nurse Practitioner | 800 Cove Parkway, Cottonwood, AZ 86326 | 2007-11-01 |
| 1003001033 | Country Care Inc | Assisted Living Facility | 3980 E Cassie Lane, Cottonwood, AZ 86326 | 2007-09-12 |
| 1154527778 | Laurel A Mueller | Family Medicine | 51 Brian Mickelsen Pkwy, Community Health Center of Yavapai, Cottonwood, AZ 86326 | 2007-06-21 |
| 1841401700 | Bruce Alan Moseng | Chiropractor | 240 Jennifer Lane, Ste 103, Cottonwood, AZ 86326 | 2007-05-24 |
| Find all providers in zip 86326 | ||||
| Taxonomy Code | 207PE0005X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Emergency Medicine |
| Specialization | Undersea and Hyperbaric Medicine |
| A specialist who treats decompression illness and diving accident cases and uses hyperbaric oxygen therapy to treat such conditions as carbon monoxide poisoning, gas gangrene, non-healing wounds, tissue damage from radiation and burns, and bone infections. This specialist also serves as a consultant to other physicians in all aspects of hyperbaric chamber operations, and assesses risks and applies appropriate standards to prevent disease and disability in divers and other persons working in altered atmospheric conditions. |
| Notes: Source: American Board of Emergency Medicine [7/1/2008: source added, additional resources added] Additional Resources: Additional Resources: www.abem.org & American Board of Preventive Medicine www.abprevmed.org |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669476412 | James Richard Kirkpatrick | Emergency Medicine | 1820 E Florence Blvd, Casa Grande, AZ 85222-5335 | 2005-06-09 |
| 1528693553 | Honorhealth Ambulatory | Emergency Medicine | 9202 N 2nd St, Phoenix, AZ 85020-2458 | 2020-03-10 |
| 1639410723 | Sanjay B Patel, Do, PC | Emergency Medicine | 16515 S 40th St, Suite 139, Phoenix, AZ 85048-0558 | 2013-03-14 |
| 1235414905 | Southwest Wound Center LLC | Emergency Medicine | 1501 W 24th St, #205, Yuma, AZ 85364-6370 | 2011-10-13 |
| 1326279050 | Carman & Co., P.C. | Emergency Medicine | 3269 Stockton Hill Rd, Hyperbaric/wound Care Center, Kingman, AZ 86409-3619 | 2009-07-29 |
| 1487803581 | John Michael Lewis, Md PC | Emergency Medicine | 1501 W 24th St, Yuma, AZ 85364-6370 | 2008-09-12 |
| 1033393566 | Phillip C. Richemont,m.d., PC | Emergency Medicine | 1501 W 24th St, Yuma, AZ 85364-6370 | 2007-12-19 |
| 1588854145 | Starfighter, LLC. | Emergency Medicine | 1501 W 24th St, Yuma, AZ 85364-6370 | 2007-07-30 |
| 1033270723 | Kenneth O Anaeme LLC | Emergency Medicine | 7615 W Thunderbird Rd Ste 106, Peoria, AZ 85381 | 2006-12-13 |
| 1285796821 | Cahmd LLC | Emergency Medicine | 6644 E Baywood Ave, Mesa, AZ 85206-1747 | 2006-12-13 |
| Find all providers with the same taxonomy | ||||
| City | COTTONWOOD |
| Zip Code | 86326 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.