Dr Isaac Jacks, MD | |
210 Wells Ave, Greenwood, SC 29646-3843 | |
(864) 943-4279 | |
Not Available |
Full Name | Dr Isaac Jacks |
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Gender | Male |
Speciality | Pediatrics |
Location | 210 Wells Ave, Greenwood, South Carolina |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1841752573 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
208000000X | Pediatrics | 91646 (Georgia) | Secondary |
208000000X | Pediatrics | 90404 (South Carolina) | Primary |
Entity Name | Self Medical Group |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1982836847 PECOS PAC ID: 6002953916 Enrollment ID: O20091027000071 |
Mailing Address | Practice Location Address |
---|---|
Dr Isaac Jacks, MD 210 Wells Ave, Greenwood, SC 29646-3843 Ph: (864) 943-4279 | Dr Isaac Jacks, MD 210 Wells Ave, Greenwood, SC 29646-3843 Ph: (864) 943-4279 |
Chacko John, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 1325 Spring St, Greenwood, SC 29646 Phone: 864-725-4449 Fax: 864-725-4452 | |
Kasonya Guerra, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 1325 Spring St, Greenwood, SC 29646 Phone: 864-725-4449 Fax: 864-725-4452 | |
Dr. Linda L Fuqua, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 210 Wells Ave, Greenwood, SC 29646 Phone: 864-943-4279 | |
Dr. Jimmell Racquel Felder, MD Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 102 Katie Ct, Greenwood, SC 29646 Phone: 864-943-4279 Fax: 864-223-2642 | |
Andrea Renee Gregory, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 155 Academy Ave, Greenwood, SC 29646 Phone: 864-725-4865 Fax: 864-725-4883 | |
Mr. Juan Miguel Bonetti, M.D. Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 113 Liner Dr, Greenwood, SC 29646 Phone: 864-941-8170 Fax: 864-388-1718 | |
Dr. Cecily S Hughes, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 210 Wells Ave, Greenwood, SC 29646 Phone: 864-943-4279 Fax: 864-223-2642 |