John Jackson (NPI# 1669433546, PAC ID# 4183798853) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is GENERAL PRACTICE.
| Nation Provider ID (NPI) | 1669433546 |
| PAC ID by PECOS | 4183798853 |
| Professional Enrollment ID | I20080730000386 |
| Full Name | John Jackson |
| Address |
410 E Cherokee St Wagoner OK 74467-4708 |
| Phone Number | 9184855591 |
| Gender | M |
| Graduation Year | 1974 |
| Primary Specialty | GENERAL PRACTICE |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 370166 | WAGONER COMMUNITY HOSPITAL |
| Address | Phone | Organization |
|---|---|---|
| 410 E Cherokee St, Wagoner, OK 74467-4708 | 9184855591 |
| Street Address |
410 E CHEROKEE ST |
| City | WAGONER |
| State | OK |
| Zip | 74467-4708 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Michele K Bucholtz | Family Medicine | 1102 W Cherokee St A, Next Generation Family Medical Clinic LLC, Wagoner, OK 74467-4600 | |
| Angela Marie Cohen | Physical Therapy | Redbud Physical Therapy LLC | 817 W Cherokee St, Wagoner, OK 74467-4616 |
| Bradley Edward Holland | Physical Therapy | Redbud Physical Rehabilitation PC | 817 W Cherokee St, Wagoner, OK 74467-4616 |
| John T Belk | Family Medicine | 1103 W Cherokee St, Wagoner, OK 74467-4621 | |
| Jeffrey A Mitchell | Optometry | 1108 W Cherokee St, Wagoner, OK 74467-4622 | |
| Harold E Goldman | Neurology | Eeg Corporation | 1200 W Cherokee, Wagoner, OK 74467-4624 |
| Kayla D Lakin Southern | Family Medicine | Wagoner Hospital Authority | 1200 W Cherokee St, Wagoner, OK 74467-4624 |
| Richard G Allen | Family Medicine | Wagoner Hospital Authority | 1200 W Cherokee St, Wagoner, OK 74467-4624 |
| Michael S Freeman | General Surgery | Wagoner Hospital Authority | 1200 W Cherokee St, Wagoner, OK 74467-4624 |
| Thai-hao Nguyen | Family Medicine | Wagoner Hospital Authority | 1200 W Cherokee St, Wagoner, OK 74467-4624 |
| Find all physicians in zip 74467 | |||
| City | WAGONER |
| Zip Code | 74467 |
| Specialty | GENERAL PRACTICE |
| City + Specialty | WAGONER + GENERAL PRACTICE |
Please comment or provide details below to improve the information on John Jackson.
| 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.