J Carvel Jackson, DO | |
303 N Centennial Way, Mesa, AZ 85201-6733 | |
(480) 649-3111 | |
(480) 649-3113 |
Full Name | J Carvel Jackson |
---|---|
Gender | Male |
Speciality | Addiction Medicine |
Experience | 36 Years |
Location | 303 N Centennial Way, Mesa, Arizona |
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 |
---|---|---|---|
1942262399 | NPI | - | NPPES |
111328 | Medicaid | AZ |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207RA0401X | Internal Medicine - Addiction Medicine | 2543 (Arizona) | Primary |
208100000X | Physical Medicine & Rehabilitation | 2543 (Arizona) | Secondary |
Entity Name | Archways Recovery Centers, Llc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1861853756 PECOS PAC ID: 0345640157 Enrollment ID: O20210616001857 |
Mailing Address | Practice Location Address |
---|---|
J Carvel Jackson, DO 303 N Centennial Way, Mesa, AZ 85201-6733 Ph: (480) 649-3111 | J Carvel Jackson, DO 303 N Centennial Way, Mesa, AZ 85201-6733 Ph: (480) 649-3111 |
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