Kenneth G Jackson Jr, MD | |
885 Tiger Blvd, Clemson, SC 29631-1480 | |
(864) 654-2067 | |
(864) 653-5926 |
Full Name | Kenneth G Jackson Jr |
---|---|
Gender | Male |
Speciality | Family Practice |
Experience | 13 Years |
Location | 885 Tiger Blvd, Clemson, South Carolina |
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 |
---|---|---|---|
1801183710 | NPI | - | NPPES |
335603 | Medicaid | SC |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | LL33560 (South Carolina) | Primary |
Facility Name | Location | Facility Type |
---|---|---|
Interim Healthcare Of The Upstate | Greenville, SC | Home health agency |
Anmed Health | Anderson, SC | Hospital |
Prisma Health Oconee Memorial Hospital | Seneca, SC | Hospital |
Prisma Health Greenville Memorial Hospital | Greenville, SC | Hospital |
Group Practice Name | Group PECOS PAC ID | No. of Members |
---|---|---|
Anmed Health | 1951215243 | 279 |
Entity Name | Anmed Health |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1164746392 PECOS PAC ID: 1951215243 Enrollment ID: O20040315000478 |
Entity Name | Anmed Health |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1427005727 PECOS PAC ID: 1951215243 Enrollment ID: O20040723000885 |
Mailing Address | Practice Location Address |
---|---|
Kenneth G Jackson Jr, MD Po Box 100174, Columbia, SC 29202-3174 Ph: (864) 512-5725 | Kenneth G Jackson Jr, MD 885 Tiger Blvd, Clemson, SC 29631-1480 Ph: (864) 654-2067 |
Edmond R Jordan, MD Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 895 Tiger Blvd, Clemson, SC 29631 Phone: 864-654-6800 Fax: 864-654-7672 | |
Manju Lakra, M.D. Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 1011 Tiger Blvd, Suite 400, Clemson, SC 29631 Phone: 864-722-0283 Fax: 864-722-0261 | |
Robert Glen Quattlebaum, M.D. Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 885 Tiger Blvd, Clemson, SC 29631 Phone: 864-512-7257 Fax: 864-654-3261 | |
Theodore Swann, MD Family Medicine Medicare: Not Enrolled in Medicare Practice Location: 386 College Ave, Clemson, SC 29631 Phone: 864-654-2067 Fax: 864-654-3261 | |
Renee A. Monaghan, M.D. Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 895 Tiger Blvd, Clemson, SC 29631 Phone: 864-512-7527 Fax: 864-654-7672 | |
Ricardo C Hood, MD Family Medicine Medicare: Not Enrolled in Medicare Practice Location: 1011 Tiger Blvd, Suite 400, Clemson, SC 29631 Phone: 864-722-0283 Fax: 888-376-4532 | |
Maria A Oliveira, MD Family Medicine Medicare: Not Enrolled in Medicare Practice Location: 735 Mcmillan Rd, Clemson, SC 29634 Phone: 864-656-2233 Fax: 864-656-0760 |