Randall Edward Jackson (NPI# 1144614165, PAC ID# 8628396736) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is NURSE PRACTITIONER.
Nation Provider ID (NPI) | 1144614165 |
PAC ID by PECOS | 8628396736 |
Professional Enrollment ID | I20150421000238 |
Full Name | Randall Edward Jackson |
Organization Legal Name | SOUTHWEST MISSISSIPPI REGIONAL MEDICAL CENTER |
Address |
215 Marion Ave Mccomb MS 39648-2705 |
Gender | M |
Graduation Year | 2015 |
Primary Specialty | NURSE PRACTITIONER |
Group Practice PAC ID | 5193633907 |
Number of Group Practice Members | 42 |
Accepts Medicare Assignment | Y |
Claim Control Number (CCN) | Legal Business Name |
---|---|
250097 | SOUTHWEST MS REGIONAL MEDICAL CENTER |
Address | Phone | Organization |
---|---|---|
1506 Aston Ave, Mccomb, MS 39648-2735 | 6012494282 | SOUTHWEST MISSISSIPPI REGIONAL MEDICAL CENTER |
212 Marion Ave, Mccomb, MS 39648-2706 | 6012491570 | SOUTHWEST MISSISSIPPI REGIONAL MEDICAL CENTER |
215 Marion Ave, Mccomb, MS 39648-2705 | SOUTHWEST MISSISSIPPI REGIONAL MEDICAL CENTER |
Organization Legal Name | SOUTHWEST MISSISSIPPI REGIONAL MEDICAL CENTER |
Physicians | 33 |
Name | Specialty | Organization | Address |
---|---|---|---|
Ronald Dwayne Delrie Jr. | Medical Oncology | Southwest Mississippi Regional Medical Center | 1501 Aston Ave, Mccomb, MS 39648-2734 |
Robert Boatwright Harris | General Surgery | Southwest Mississippi Regional Medical Center | 1311 Aston Ave, Mccomb, MS 39648-2825 |
Jordan Harrington | Nurse Practitioner | Southwest Mississippi Regional Medical Center | 303 Marion Ave, Mccomb, MS 39648-2707 |
Patrick B Wood | Family Medicine | Southwest Mississippi Regional Medical Center | 1167 E Broad St, Monticello, MS 39654-7682 |
Carl R Feind | Interventional Cardiology | Southwest Mississippi Regional Medical Center | 215 Marion Ave, Mccomb, MS 39648-2705 |
Dany Haddad | Internal Medicine | Southwest Mississippi Regional Medical Center | 215 Marion Ave, Mccomb, MS 39648-2705 |
Mary W Thornton | Nurse Practitioner | Southwest Mississippi Regional Medical Center | 215 Marion Ave, Mccomb, MS 39648-2705 |
Craig V Adams | Cardiac Surgery | Southwest Mississippi Regional Medical Center | 215 Marion Ave, Mccomb, MS 39648-2705 |
James A Nobles | Obstetrics/gynecology | Southwest Mississippi Regional Medical Center | 215 Marion Ave, Mccomb, MS 39648-2705 |
William N Dixon | General Surgery | Southwest Mississippi Regional Medical Center | 215 Marion Ave, Mccomb, MS 39648-2705 |
Street Address |
215 MARION AVE |
City | MCCOMB |
State | MS |
Zip | 39648-2705 |
Name | Specialty | Organization | Address |
---|---|---|---|
Ashraf E Riad | Anesthesiology | Mccomb Anesthesia Associates, LLP | 215 Marion Ave, Mccomb, MS 39648-2705 |
Carl R Feind | Interventional Cardiology | Southwest Mississippi Regional Medical Center | 215 Marion Ave, Mccomb, MS 39648-2705 |
Warren J Anderson | Certified Registered Nurse Anesthetist (crna) | Mccomb Anesthesia Associates, LLP | 215 Marion Ave, Mccomb, MS 39648-2705 |
Dany Haddad | Internal Medicine | Southwest Mississippi Regional Medical Center | 215 Marion Ave, Mccomb, MS 39648-2705 |
Mary W Thornton | Nurse Practitioner | Southwest Mississippi Regional Medical Center | 215 Marion Ave, Mccomb, MS 39648-2705 |
Rachel M Spiers | Certified Registered Nurse Anesthetist (crna) | Mccomb Anesthesia Associates, LLP | 215 Marion Ave, Mccomb, MS 39648-2705 |
Craig V Adams | Cardiac Surgery | Southwest Mississippi Regional Medical Center | 215 Marion Ave, Mccomb, MS 39648-2705 |
Rhonda J Thomas | Nurse Practitioner | Mississippi Em-i Medical Services PC | 215 Marion Ave, Mccomb, MS 39648-2705 |
Marc B Freeman | Anesthesiology | Mccomb Anesthesia Associates, LLP | 215 Marion Ave, Mccomb, MS 39648-2705 |
Robert K Walker | Emergency Medicine | Streambed Emergency Physicians LLC | 215 Marion Ave, Mccomb, MS 39648-2705 |
Find all physicians in the same address |
Name | Specialty | Organization | Address |
---|---|---|---|
David Scott Snow | Family Medicine | 1121 Hwy 98/51, Summit, MS 39648 | |
Damon S Spears | Nurse Practitioner | Maxem Health Urgent Care Mccomb | 101 Edgewood Dr, Mccomb, MS 39648-2043 |
Tonya Brister | Nurse Practitioner | Maxem Health Urgent Care Mccomb | 101 Edgewood Dr, Mccomb, MS 39648-2043 |
James Stephen Moore | Optometry | 1722 Veterans Blvd, C2, Mccomb, MS 39648-2052 | |
Kimberly F Harrell | Optometry | 1608 Veterans Blvd, Mccomb, MS 39648-2064 | |
Kappi F Rushing | Nurse Practitioner | Mccomb Og-gyn Associated | 205 Marion Ave, Mccomb, MS 39648-2705 |
James A Nobles | Obstetrics/gynecology | Southwest Mississippi Regional Medical Center | 215 Marion Ave, Mccomb, MS 39648-2705 |
Kasie S Holmes | Nurse Practitioner | Mccomb Og-gyn Associated | 205 Marion Ave, Mccomb, MS 39648-2705 |
Karen D Nelms | Certified Registered Nurse Anesthetist (crna) | Mccomb Anesthesia Associates, LLP | 215 Marion Ave, Mccomb, MS 39648-2705 |
Jarrod P Fontenelle | Certified Registered Nurse Anesthetist (crna) | Mccomb Anesthesia Associates, LLP | 215 Marion Ave, Mccomb, MS 39648-2705 |
Find all physicians in zip 39648 |
City | MCCOMB |
Zip Code | 39648 |
Specialty | NURSE PRACTITIONER |
City + Specialty | MCCOMB + NURSE PRACTITIONER |
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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.