Terrance Lamont Jackson Sr, is a
Point Of Service based in Canton, Ohio. Terrance Lamont Jackson Sr is licensed to practice in * (Not Available) (license number ) and his current practice location is
2155 Georgetown Rd Ne, Canton, Ohio. He can be reached at his office (for appointments etc.) via phone at
(816) 377-7225.
NPI number for Terrance Lamont Jackson Sr is 1467134544 and his current mailing address is 2155 Georgetown Rd Ne, Canton, Ohio. He
does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1467134544.
Healthcare Provider's Profile
Full Name | Terrance Lamont Jackson Sr |
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Gender | Male |
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Speciality | Point Of Service |
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Location | 2155 Georgetown Rd Ne, Canton, Ohio |
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Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
NPI Data:
- NPI Number: 1467134544
- Provider Enumeration Date: 08/07/2023
- Last Update Date: 08/07/2023
Medical Identifiers
Medical identifiers for Terrance Lamont Jackson Sr such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1467134544 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
101Y00000X | Counselor | (* (Not Available)) | Secondary |
305S00000X | Point Of Service | (* (Not Available)) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Terrance Lamont Jackson Sr is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
Terrance Lamont Jackson Sr, 2155 Georgetown Rd Ne, Canton, OH 44704-2257 Ph: (816) 377-7225 | Terrance Lamont Jackson Sr, 2155 Georgetown Rd Ne, Canton, OH 44704-2257 Ph: (816) 377-7225 |
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