Mark R Jackson (NPI# 1003877077, PAC ID# 5991740599) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is EMERGENCY MEDICINE.
Nation Provider ID (NPI) | 1003877077 |
PAC ID by PECOS | 5991740599 |
Professional Enrollment ID | I20050623000912 |
Full Name | Mark R Jackson |
Organization Legal Name | COVENANT MEDICAL GROUP |
Address |
3615 19th St Lubbock TX 79410-1894 |
Phone Number | 8067251011 |
Gender | M |
Credential | MD |
Medical School | UNIVERSITY OF UTAH SCHOOL OF MEDICINE |
Graduation Year | 1995 |
Primary Specialty | EMERGENCY MEDICINE |
Secondary Specialties | INTERNAL MEDICINE |
Group Practice PAC ID | 6901889393 |
Number of Group Practice Members | 170 |
Accepts Medicare Assignment | Y |
Claim Control Number (CCN) | Legal Business Name |
---|---|
321300 | SIERRA VISTA HOSPITAL |
450040 | COVENANT MEDICAL CENTER |
Address | Phone | Organization |
---|---|---|
3615 19th St, Lubbock, TX 79410-1894 | 8067251011 | COVENANT MEDICAL GROUP |
800 E 9th Ave, Truth Or Consequences, NM 87901-1954 | 5758942111 | EMERGENCY STAFFING SOLUTIONS INC |
Organization Legal Name | COVENANT MEDICAL GROUP |
Physicians | 185 |
Name | Specialty | Organization | Address |
---|---|---|---|
Ryan C Owen | Urology | Covenant Medical Group | 3612 23rd St, Lubbock, TX 79410-1326 |
David F Oakes | Cardiac Electrophysiology | Covenant Medical Group | 3506 21st St, Suite 302, Lubbock, TX 79410-1212 |
Kyler W Barkley | Cardiovascular Disease (cardiology) | Covenant Medical Group | 3514 21st St, Lubbock, TX 79410-1210 |
Joshua G Hill | Family Medicine | Covenant Medical Group | 611 N Frankford Ave, Lubbock, TX 79416-1545 |
Prakash Shrestha | Infectious Disease | Covenant Medical Group | 3801 21st St, Suite 200, Lubbock, TX 79410-1006 |
Stacy E Neudorf | Physician Assistant | Covenant Medical Group | 2201 Oxford, Lubbock, TX 79410 |
Kia M Ousley | Family Medicine | Covenant Medical Group | 1910 Quaker Ave, Suite 101, Lubbock, TX 79407-2447 |
Jana C Ashburn | Nurse Practitioner | Covenant Medical Group | 3606 21st St, Suite 103, Lubbock, TX 79410-1226 |
Kate E Barnett | Physical Therapy | Covenant Medical Group | 4404 19th St, Suite C, Lubbock, TX 79407-2424 |
Cristan D Ledbetter | Nurse Practitioner | Covenant Medical Group | 4102 22nd Pl, Lubbock, TX 79410-1122 |
Street Address |
3615 19TH ST |
City | LUBBOCK |
State | TX |
Zip | 79410-1894 |
Name | Specialty | Organization | Address |
---|---|---|---|
Janine Valosky | Internal Medicine | Hospitalist Medicine Physicians of Texas Pllc | 3615 19th St, Lubbock, TX 79410-1203 |
Md S Hossin | Internal Medicine | Hospitalist Medicine Physicians of Texas Pllc | 3615 19th St, Lubbock, TX 79410-1203 |
Alexandra D Bates | Nurse Practitioner | Covenant Medical Group | 3615 19th St, Lubbock, TX 79410-1894 |
Bharat Bhushan | Hospitalist | Hospitalist Medicine Physicians of Texas Pllc | 3615 19th St, Lubbock, TX 79410-1203 |
Gilbert Carroll Brown Iii | Anesthesiology | Northstar Anesthesia Pa | 3615 19th St, Lubbock, TX 79410-1203 |
Hannah L Coram | Emergency Medicine | Covenant Medical Group | 3615 19th St, Lubbock, TX 79410-1894 |
Seshadri D Thirumala | Pathology | Ameripath Lubbock 501a Corporation | 3615 19th St, Lubbock, TX 79410-1203 |
Omar Salh | Hospitalist | Hospitalist Medicine Physicians of Texas Pllc | 3615 19th St, Lubbock, TX 79410-1203 |
Stan S Rice | Emergency Medicine | Covenant Medical Group | 3615 19th St, Lubbock, TX 79410-1894 |
Michele A Dela Garza | Nurse Practitioner | Hospitalist Medicine Physicians of Texas Pllc | 3615 19th St, Lubbock, TX 79410-1203 |
Find all physicians in the same address |
Name | Specialty | Organization | Address |
---|---|---|---|
Stacy E Neudorf | Physician Assistant | Covenant Medical Group | 2201 Oxford, Lubbock, TX 79410 |
Allison P Vaughn | Nurse Practitioner | Covenant Medical Group | 2102 Oxford A, Lubbock, TX 79410 |
Amelia Jay | Nurse Practitioner | Covenant Medical Group | 2102 Oxford B, Lubbock, TX 79410 |
Clinton G Wolboldt | Family Practice | Covenant Medical Group | 2102 Oxford A, Lubbock, TX 79410 |
Darla K Walker | Nurse Practitioner | Covenant Medical Group | 2201 Oxford, Lubbock, TX 79410 |
Prakash Shrestha | Infectious Disease | Covenant Medical Group | 3801 21st St, Suite 200, Lubbock, TX 79410-1006 |
Larry A Warmoth | Nephrology | 3801 21st St, Suite 200, Lubbock, TX 79410-1006 | |
Melissa Mae Wotring-norman | Hospitalist | 3801 21st St, Suite 200, Lubbock, TX 79410-1006 | |
Paul S Singh | Obstetrics/gynecology | Covenant Medical Group | 3801 21st St, Suite 200, Lubbock, TX 79410-1006 |
Lakhu J Rohra | Internal Medicine | 3802 21st St, Suite C, Lubbock, TX 79410-1011 | |
Find all physicians in zip 79410 |
City | LUBBOCK |
Zip Code | 79410 |
Specialty | EMERGENCY MEDICINE |
City + Specialty | LUBBOCK + EMERGENCY MEDICINE |
Please comment or provide details below to improve the information on Mark R 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.