Dr Stephen W Jackson, MD | |
400 Berywood Trl Nw, Suite B, Cleveland, TN 37312-5287 | |
(423) 472-3201 | |
(423) 476-4949 |
Full Name | Dr Stephen W Jackson |
---|---|
Gender | Male |
Speciality | Urology |
Experience | 41 Years |
Location | 400 Berywood Trl Nw, Cleveland, Tennessee |
Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
Identifier | Type | State | Issuer |
---|---|---|---|
1386609808 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
208800000X | Urology | MD017093 (Tennessee) | Primary |
Facility Name | Location | Facility Type |
---|---|---|
Methodist Medical Center Of Illinois | Peoria, IL | Hospital |
Proctor Hospital | Peoria, IL | Hospital |
Group Practice Name | Group PECOS PAC ID | No. of Members |
---|---|---|
Methodist Medical Center Of Illinois | 1355259714 | 246 |
Entity Name | Methodist Medical Center Of Illinois |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1982656575 PECOS PAC ID: 1355259714 Enrollment ID: O20031126000494 |
Mailing Address | Practice Location Address |
---|---|
Dr Stephen W Jackson, MD 400 Berywood Trl Nw, Suite B, Cleveland, TN 37312-5287 Ph: (423) 472-3201 | Dr Stephen W Jackson, MD 400 Berywood Trl Nw, Suite B, Cleveland, TN 37312-5287 Ph: (423) 472-3201 |
Daniel Box, Urology Medicare: Accepting Medicare Assignments Practice Location: 400 Berywood Trl Nw Ste B, Cleveland, TN 37312 Phone: 423-472-3201 Fax: 423-476-4949 | |
Edward M Mcintire Jr., M.D. Urology Medicare: Accepting Medicare Assignments Practice Location: 400 Berywood Trl Nw, Suite B, Cleveland, TN 37312 Phone: 423-472-3201 Fax: 423-476-4949 | |
Mr. Joseph Alexander Ivey Iii, Urology Medicare: Accepting Medicare Assignments Practice Location: 400 Berywood Trl Nw Ste B, Cleveland, TN 37312 Phone: 423-472-3201 Fax: 423-476-4949 | |
Dr. Christopher C Thacker, M.D. Urology Medicare: Accepting Medicare Assignments Practice Location: 400 Berywood Trl Nw, Suite B, Cleveland, TN 37312 Phone: 423-472-3201 Fax: 423-476-4949 | |
Dr. Grant Pegram Simmons, M.D. Urology Medicare: Not Enrolled in Medicare Practice Location: 400 Berywood Trl Nw Ste B, Cleveland, TN 37312 Phone: 423-472-3201 Fax: 423-476-4949 |