Phillip R Jackson (NPI# 1770920928, PAC ID# 6608000583) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is CLINICAL SOCIAL WORKER.
| Nation Provider ID (NPI) | 1770920928 |
| PAC ID by PECOS | 6608000583 |
| Professional Enrollment ID | I20131008001278 |
| Full Name | Phillip R Jackson |
| Organization Legal Name | CENTURY LIVING INC |
| Address |
4777 E Outer Dr Detroit MI 48234-3241 |
| Phone Number | 3133695800 |
| Gender | M |
| Graduation Year | 1975 |
| Primary Specialty | CLINICAL SOCIAL WORKER |
| Group Practice PAC ID | 7113236472 |
| Number of Group Practice Members | 9 |
| Accepts Medicare Assignment | Y |
| Address | Phone | Organization |
|---|---|---|
| 4777 E Outer Dr, Detroit, MI 48234-3241 | 3133695800 | CENTURY LIVING INC |
| Organization Legal Name | CENTURY LIVING INC |
| Physicians | 2 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Shahzad Ahmed Farooqi | Psychiatry | Century Living Inc | 4777 E Outer Dr, Detroit, MI 48234-3241 |
| Street Address |
4777 E OUTER DR |
| City | DETROIT |
| State | MI |
| Zip | 48234-3241 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Eric Jacob Greenberg | Emergency Medicine | 4777 E Outer Dr, Detroit, MI 48234-3241 | |
| Idalys Ortega Sotolongo | Nurse Practitioner | Ribhi Hazin Md PC | 4777 E Outer Dr, Suite 1147, Detroit, MI 48234-3241 |
| Shahzad Ahmed Farooqi | Psychiatry | Century Living Inc | 4777 E Outer Dr, Detroit, MI 48234-3241 |
| Marcia Antoinette Murphy | Nurse Practitioner | Procare Partners Health Pllc | 4777 E Outer Dr, Suite 1147, Detroit, MI 48234-3241 |
| Kenneth Warren | Clinical Social Worker | 4777 E Outer Dr, Detroit, MI 48234-3241 | |
| Michael Rubin | Ophthalmology | Patrick G Murray Eye Center PC | 4777 E Outer Dr, Detroit, MI 48234-3241 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Blessen Samuel | Physical Therapy | Gilead Traumatic Brain and Back Rehab LLC | 2328 E 7 Mile Rd, 3 Gilead Rehab, Detroit, MI 48234-1304 |
| Gigi John | Physical Therapy | Gilead Traumatic Brain and Back Rehab LLC | 2328 E 7 Mile Rd, 3 Gilead Rehab, Detroit, MI 48234-1304 |
| Zakari M Tata | Family Medicine | Institute of Supportive Services Inc | 19940 Conant St, Suite B, Detroit, MI 48234-1494 |
| Andrew J Ruden | Internal Medicine | Institute of Supportive Services Inc | 19940 Conant St, Suite B, Detroit, MI 48234-1494 |
| Kathryn Douglass | Clinical Social Worker | 8200 Rolyat St, Detroit, MI 48234-3358 | |
| Laneice Jones | Clinical Social Worker | 8200 Rolyat St, Detroit, MI 48234-3358 | |
| Ernest A Mullen | Family Medicine | 19431 Van Dyke St, Detroit, MI 48234-3393 | |
| Inga Monae Leverett | Nurse Practitioner | The Wellness Plan Medical Centers | 4909 E Outer Dr, Detroit, MI 48234-3446 |
| Jacita Greve | Nurse Practitioner | The Wellness Plan Medical Centers | 4909 E Outer Dr, Detroit, MI 48234-3446 |
| Takisha Lashore | Clinical Social Worker | 11401 E 7 Mile Rd, Detroit, MI 48234-3707 | |
| Find all physicians in zip 48234 | |||
| City | DETROIT |
| Zip Code | 48234 |
| Specialty | CLINICAL SOCIAL WORKER |
| City + Specialty | DETROIT + CLINICAL SOCIAL WORKER |
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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.