Lawrence Richard Jackson Jr, MD is a medicare enrolled "Family Medicine" physician in Waverly, Tennessee. His current practice location is
104 Hillwood Dr, Waverly, Tennessee. You can reach out to his office (for appointments etc.) via phone at
(931) 296-3555.
Lawrence Richard Jackson Jr is licensed to practice in Tennessee (license number MD0000020215) and he also participates in the medicare program. He
accepts medicare assignments (which means he accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and his NPI Number is 1386794816.
Physician's Profile
| Full Name | Lawrence Richard Jackson Jr |
|---|
| Gender | Male |
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| Speciality | |
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| Experience | Years |
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| Location | 104 Hillwood Dr, Waverly, Tennessee |
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| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
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Medical Education and Training:
- Lawrence Richard Jackson Jr attended and graduated from in
NPI Data:
- NPI Number: 1386794816
- Provider Enumeration Date: 01/10/2007
- Last Update Date: 08/07/2023
Medicare PECOS Information:
- PECOS PAC ID:
- Enrollment ID:
Medical Identifiers
Medical identifiers for Lawrence Richard Jackson Jr such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1386794816 | NPI | - | NPPES |
| 223121700 | Other | TN | DEPT OF LABOR |
| 0151975 | Other | TN | BCBS |
| 3724150 | Medicaid | TN | |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 207Q00000X | Family Medicine | 20215 (Tennessee) | Secondary |
| 207Q00000X | Family Medicine | MD0000020215 (Tennessee) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Lawrence Richard Jackson Jr is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Lawrence Richard Jackson Jr, MD
Po Box 270,
Waverly, TN 37185-0270
Ph: (931) 296-3555 | Lawrence Richard Jackson Jr, MD
104 Hillwood Dr,
Waverly, TN 37185-2116
Ph: (931) 296-3555 |
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