| Laura Jackson, LD | |
|
30381 Chieftain Dr, Logan, OH 43138-9092 | |
| (740) 385-2555 | |
| (740) 773-4032 |
| Full Name | Laura Jackson |
|---|---|
| Gender | Female |
| Speciality | Dietitian, Registered |
| Location | 30381 Chieftain Dr, Logan, Ohio |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1073103321 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 133V00000X | Dietitian, Registered | (* (Not Available)) | Primary |
| Provider Name | Hopewell Health Centers Inc |
|---|---|
| Provider Type | Part B Supplier - Clinic/group Practice |
| Provider Identifiers | NPI Number: 1699010348 PECOS PAC ID: 9234049990 Enrollment ID: O20110209000712 |
| Mailing Address | Practice Location Address |
|---|---|
| Laura Jackson, LD Po Box 188, Chillicothe, OH 45601-0188 Ph: (740) 773-4366 | Laura Jackson, LD 30381 Chieftain Dr, Logan, OH 43138-9092 Ph: (740) 385-2555 |
Addy L Mathias, LD Dietitian Medicare: Not Enrolled in Medicare Practice Location: 30381 Chieftain Dr, Logan, OH 43138 Phone: 740-385-2555 Fax: 740-773-4032 | |
Mrs. Denise Kiamy, RDN, LD Dietitian Medicare: Not Enrolled in Medicare Practice Location: 601 State Route 664 N, Logan, OH 43138 Phone: 740-380-8242 Fax: 740-380-8032 | |
Stefanie Lynn, M.S., R.D. Dietitian Medicare: Not Enrolled in Medicare Practice Location: 30381 Chieftain Dr, Logan, OH 43138 Phone: 740-385-2555 | |
Alicia Woods, LD Dietitian Medicare: Not Enrolled in Medicare Practice Location: 30381 Chieftain Dr, Logan, OH 43138 Phone: 740-385-2555 Fax: 740-773-4032 |