Dr Charles West Jacocks Iv, MD | |
2300 Ramsey St Rm 304-a, Fayetteville, NC 28301-3856 | |
(910) 488-2120 | |
Not Available |
Full Name | Dr Charles West Jacocks Iv |
---|---|
Gender | Male |
Speciality | Internal Medicine - Cardiovascular Disease |
Location | 2300 Ramsey St Rm 304-a, Fayetteville, North Carolina |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1720051105 | NPI | - | NPPES |
141144 | Medicaid | SC |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207RC0000X | Internal Medicine - Cardiovascular Disease | 14114 (South Carolina) | Primary |
Entity Name | Prisma Health Tuomey |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1548625593 PECOS PAC ID: 2163728528 Enrollment ID: O20160310001016 |
Mailing Address | Practice Location Address |
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Dr Charles West Jacocks Iv, MD 2300 Ramsey St Rm 304-a, Fayetteville, NC 28301-3856 Ph: (910) 488-2120 | Dr Charles West Jacocks Iv, MD 2300 Ramsey St Rm 304-a, Fayetteville, NC 28301-3856 Ph: (910) 488-2120 |
Kenneth Melton, M.D. Cardiovascular Disease Medicare: Accepting Medicare Assignments Practice Location: 557 Sandhurst Dr, Fayetteville, NC 28304 Phone: 910-484-8114 Fax: 910-484-1564 | |
Kenneth Russell Manning, M.D. Cardiovascular Disease Medicare: Accepting Medicare Assignments Practice Location: 1638 Owen Dr, Fayetteville, NC 28304 Phone: 910-609-6910 Fax: 910-609-5219 | |
San San Wai, M.D. Cardiovascular Disease Medicare: Medicare Enrolled Practice Location: 2300 Ramsey St, Va Medical Center, Fayetteville, NC 28301 Phone: 910-488-2120 | |
Dr. Sabena Johnson, MD Cardiovascular Disease Medicare: Accepting Medicare Assignments Practice Location: 2300 Ramsey St, Fayetteville, NC 28301 Phone: 910-488-2120 | |
Dr. Stephen S Logue, M.D. Cardiovascular Disease Medicare: Medicare Enrolled Practice Location: 1843 Quiet Cv, Fayetteville, NC 28304 Phone: 910-483-8080 Fax: 910-483-3258 | |
David Tat, DO Cardiovascular Disease Medicare: Accepting Medicare Assignments Practice Location: 1601 Owen Dr, Fayetteville, NC 28304 Phone: 910-678-0100 Fax: 910-678-0110 | |
Dr. Ghanshyam Pradyumna Dwivedi, MD Cardiovascular Disease Medicare: Accepting Medicare Assignments Practice Location: 1778 Metromedical Dr, Fayetteville, NC 28304 Phone: 910-483-4680 Fax: 910-484-2704 |