Dr Andrew Lee Jackson, DMD is a medicare enrolled "Dentist - General Practice" provider in Willacoochie, Georgia. His current practice location is
600 Mccranie Avenue, Willacoochie, Georgia. You can reach out to his office (for appointments etc.) via phone at
(912) 534-5164.
Dr Andrew Lee Jackson is licensed to practice in Georgia (license number 9939) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1568591287.
Healthcare Provider's Profile
Full Name | Dr Andrew Lee Jackson |
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Gender | Male |
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Speciality | Dentist - General Practice |
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Location | 600 Mccranie Avenue, Willacoochie, Georgia |
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Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
NPI Data:
- NPI Number: 1568591287
- Provider Enumeration Date: 03/06/2007
- Last Update Date: 07/08/2007
Medicare PECOS Information:
- PECOS PAC ID: 1456655117
- Enrollment ID: I20160201002401
Medical Identifiers
Medical identifiers for Dr Andrew Lee Jackson such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1568591287 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
1223G0001X | Dentist - General Practice | 9939 (Georgia) | 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. Dr Andrew Lee Jackson is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
Dr Andrew Lee Jackson, DMD Po Box 206, Willacoochee, GA 31650 Ph: (912) 534-5164 | Dr Andrew Lee Jackson, DMD 600 Mccranie Avenue, Willacoochie, GA 31650 Ph: (912) 534-5164 |
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