Christopher Jackson, LAC | |
105 Highway 9, Oxford, AR 72565-0096 | |
(501) 315-3344 | |
Not Available |
Full Name | Christopher Jackson |
---|---|
Gender | Male |
Speciality | Counselor - Professional |
Location | 105 Highway 9, Oxford, Arkansas |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1558545897 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
101YP2500X | Counselor - Professional | P1109067 (Arkansas) | Primary |
101Y00000X | Counselor | (Arkansas) | Secondary |
Entity Name | Birch Tree Communities Inc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1770733768 PECOS PAC ID: 5597749747 Enrollment ID: O20040615001261 |
Mailing Address | Practice Location Address |
---|---|
Christopher Jackson, LAC Po Box 1589, Benton, AR 72018-1589 Ph: (501) 315-3344 | Christopher Jackson, LAC 105 Highway 9, Oxford, AR 72565-0096 Ph: (501) 315-3344 |
Gale Tinsman, Counselor Medicare: Not Enrolled in Medicare Practice Location: 105 Hwy 9, Oxford, AR 72565 Phone: 870-258-3305 Fax: 879-258-3244 | |
Holly Nottingham, Counselor Medicare: Not Enrolled in Medicare Practice Location: 105 Highway 9, Oxford, AR 72565 Phone: 501-315-3344 | |
Tayler Thomason, Counselor Medicare: Not Enrolled in Medicare Practice Location: 105 Highway 9, Oxford, AR 72565 Phone: 501-315-3344 | |
Merinda Jackson, LAC Counselor Medicare: Medicare Enrolled Practice Location: 105 Hwy 9, Oxford, AR 72565 Phone: 870-258-3244 |