Theresa N Jackson (NPI# 1164818993, PAC ID# 4183902562) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is GENERAL SURGERY.
| Nation Provider ID (NPI) | 1164818993 |
| PAC ID by PECOS | 4183902562 |
| Professional Enrollment ID | I20190515001553 |
| Full Name | Theresa N Jackson |
| Organization Legal Name | ESS OF STILWELL, LLC |
| Address |
1401 W Locust St Stilwell Memorial Hospital Stilwell OK 74960-3275 |
| Phone Number | 9186963101 |
| Gender | F |
| Medical School | UNIVERSITY OF OKLAHOMA COLLEGE OF MEDICINE |
| Graduation Year | 2015 |
| Primary Specialty | GENERAL SURGERY |
| Group Practice PAC ID | 8527398940 |
| Number of Group Practice Members | 10 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 371328 | ARBUCKLE MEMORIAL HOSPITAL |
| 370178 | MEMORIAL HOSPITAL |
| 370112 | SEQUOYAH COUNTY-CITY OF SALLISAW HOSPITAL AUTHORIT |
| Address | Phone | Organization |
|---|---|---|
| 1401 W Locust St, Stilwell Memorial Hospital, Stilwell, OK 74960-3275 | 9186963101 | ESS OF STILWELL, LLC |
| Organization Legal Name | ESS OF STILWELL, LLC |
| Physicians | 3 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Mario Roldan | General Surgery | Ess of Stilwell, LLC | 1401 W Locust St, Stilwell Memorial Hospital, Stilwell, OK 74960-3275 |
| Daniel Gragert | Family Medicine | Ess of Stilwell, LLC | 1401 W Locust St, Stilwell Memorial Hospital, Stilwell, OK 74960-3275 |
| Street Address |
1401 W LOCUST ST STILWELL MEMORIAL HOSPITAL |
| City | STILWELL |
| State | OK |
| Zip | 74960-3275 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Mario Roldan | General Surgery | Ess of Stilwell, LLC | 1401 W Locust St, Stilwell Memorial Hospital, Stilwell, OK 74960-3275 |
| Wojciech L Dulowski | Family Medicine | Adair County Health Center Inc | 1401 W Locust St, Stilwell, OK 74960-3275 |
| Wanda F Butler | Nurse Practitioner | Adair County Health Center Inc | 1401 W Locust St, Stilwell, OK 74960-3275 |
| Racheal Imelda Brady | Nurse Practitioner | Adair County Health Center Inc | 1401 W Locust St, Suite 102, Stilwell, OK 74960-3276 |
| Adrian Sarah Unger | Nurse Practitioner | Adair County Health Center Inc | 1401 W Locust St, Suite 102, Stilwell, OK 74960-3276 |
| Jeffery L Jenkins | Family Medicine | Adair County Health Center Inc | 1401 W Locust St, Suite 102, Stilwell, OK 74960-3276 |
| Gitanjali Pai | Infectious Disease | Adair County Health Center Inc | 1401 W Locust St, Stilwell, OK 74960-3275 |
| Donna Ann Dansby | Nurse Practitioner | Adair County Health Center Inc | 1401 W Locust St, Stilwell, OK 74960-3275 |
| Steven G Brannan | Certified Registered Nurse Anesthetist (crna) | Adair County Health Center Inc | 1401 W Locust St, Stilwell, OK 74960-3275 |
| Eric W Simons | Obstetrics/gynecology | Adair County Health Center Inc | 1401 W Locust St, Stilwell, OK 74960-3275 |
| Find all physicians in the same address | |||
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Jimmie W Taylor | General Practice | 735 W Locust St, Hwy 100 West, Stilwell, OK 74960-0820 | |
| Alberto H Delcorro | General Surgery | Adair County Health Center, Inc. | 1401 W Locust St, Stilwell, OK 74960-3217 |
| Emmanuel N Macaraeg | Anesthesiology | Adair County Health Center Inc | 1401 W Locust St, Stilwell, OK 74960-3275 |
| Daniel Gragert | Family Medicine | Ess of Stilwell, LLC | 1401 W Locust St, Stilwell Memorial Hospital, Stilwell, OK 74960-3275 |
| Elise R Cooper-horne | Registered Dietitian Or Nutrition Professional | Adair County Health Center Inc | 1401 W Locust St, Stilwell, OK 74960-3275 |
| Patricia G Burns | Pediatric Medicine | Adair County Health Center Inc | 1401 W Locust St, Stilwell, OK 74960-3275 |
| Vikrant L Landge | Orthopedic Surgery | Adair County Health Center Inc | 1401 W Locust St, Suite 102, Stilwell, OK 74960-3276 |
| Nicholas J Bentley | Family Medicine | Adair County Health Center Inc | 1401 W Locust St, Suite 102, Stilwell, OK 74960-3276 |
| Krystal Leigh Stewart | Physician Assistant | Adair County Health Center Inc | 1401 W Locust St, Suite 102, Stilwell, OK 74960-3276 |
| Dennis L Martin | Family Practice | Dennis L. Martin M.d., PC | 912 W Cedar St, Stilwell, OK 74960-3406 |
| Find all physicians in zip 74960 | |||
| City | STILWELL |
| Zip Code | 74960 |
| Specialty | GENERAL SURGERY |
| City + Specialty | STILWELL + GENERAL SURGERY |
Please comment or provide details below to improve the information on Theresa N 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.