Charles E Jackson Jr. (NPI# 1366658734, PAC ID# 2961526454) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is GENERAL PRACTICE.
| Nation Provider ID (NPI) | 1366658734 |
| PAC ID by PECOS | 2961526454 |
| Professional Enrollment ID | I20100907000333 |
| Full Name | Charles E Jackson Jr. |
| Organization Legal Name | COMMUNITY HEALTH CARE SYSTEMS, INC. |
| Address |
107 Fairview Park Dr Dublin GA 31021-2501 |
| Phone Number | 47886434482204 |
| Gender | M |
| Medical School | MEHARRY MEDICAL COLLEGE SCHOOL OF MEDICINE |
| Graduation Year | 1971 |
| Primary Specialty | GENERAL PRACTICE |
| Group Practice PAC ID | 5890783179 |
| Number of Group Practice Members | 12 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 110125 | FAIRVIEW PARK HOSPITAL |
| Address | Phone | Organization |
|---|---|---|
| 107 Fairview Park Dr, Dublin, GA 31021-2501 | 47886434482204 | COMMUNITY HEALTH CARE SYSTEMS, INC. |
| Organization Legal Name | COMMUNITY HEALTH CARE SYSTEMS, INC. |
| Physicians | 12 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Lynn Denny | Family Medicine | Community Health Care Systems, Inc. | 102 A Airport Rd Ne, Milledgeville, GA 31061-9313 |
| Alesha Edwards | Podiatry | Community Health Care Systems, Inc. | 616 Ferncrest Dr, Sandersville, GA 31082-1863 |
| Keisha Renee Callins | Obstetrics/gynecology | Community Health Care Systems, Inc. | 4292 Gray Hwy, Gray, GA 31032-5900 |
| Bridgett C Bailey | Family Medicine | Community Health Care Systems, Inc. | 557 A Broad St Nw, Crawfordville, GA 30631-2918 |
| Oscar H Salvat | Internal Medicine | Community Health Care Systems, Inc. | 2251 W Elm St, Wrightsville, GA 31096-2017 |
| Israel D Bryson | Family Medicine | Community Health Care Systems, Inc. | 623 N Main St, Wrens, GA 30833-1178 |
| Kent Douglass Ford | Family Medicine | Community Health Care Systems, Inc. | 616 Ferncrest Dr, Sandersville, GA 31082-1863 |
| Brian D Siddall | General Practice | Community Health Care Systems, Inc. | 2251 W Elm St, Wrightsville, GA 31096-2017 |
| Paula Fields | Clinical Social Worker | Community Health Care Systems, Inc. | 2251 W Elm St, Wrightsville, GA 31096-2017 |
| Cherilyn Smith Zellner | Family Medicine | Community Health Care Systems, Inc. | 616 Ferncrest Dr, Sandersville, GA 31082-1863 |
| Street Address |
107 FAIRVIEW PARK DR |
| City | DUBLIN |
| State | GA |
| Zip | 31021-2501 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| William D Taylor | Geriatric Medicine | Southeast Geriatrics Inc | 160 Springbranch Dr, Dublin, GA 31021 |
| Chaquita M Moore | Nurse Practitioner | Southeast Geriatrics Inc | 160 Springbranch Dr, Dublin, GA 31021 |
| Amanda K Smith | Nurse Practitioner | Southeast Geriatrics Inc | 160 Springbranch Dr, Dublin, GA 31021 |
| Shelley H Pool | Nurse Practitioner | Southeast Geriatrics Inc | 160 Springbranch Dr, Dublin, GA 31021 |
| Laura D Mullis | Nurse Practitioner | Southeast Geriatrics Inc | 160 Springbranch Dr, Dublin, GA 31021 |
| Jane B Holleman | Physical Therapy | 612 Country Club Rd, Dublin, GA 31021-0112 | |
| William Alfred Cox | Optometry | 2423 Us Hwy 80 W, C/o The Vision Center, Dublin, GA 31021-0930 | |
| Melissa F Gay | Qualified Audiologist | Dublin Ear Nose and Throat Associates, P.C. | 102 Fairview Park Dr, Dublin, GA 31021-2500 |
| Matthew B Grundfast | Gastroenterology | Gastroenterology Associates of Dublin LLC | 104 Fairview Park Dr, Dublin, GA 31021-2500 |
| Thomas Corbin Mullis | Otolaryngology | Dublin Ear Nose and Throat Associates, P.C. | 102 Fairview Park Dr, Dublin, GA 31021-2500 |
| Find all physicians in zip 31021 | |||
| City | DUBLIN |
| Zip Code | 31021 |
| Specialty | GENERAL PRACTICE |
| City + Specialty | DUBLIN + GENERAL PRACTICE |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.