Mr Thomas Michael Jackson, DO is a
Emergency Medicine physician based in Carmen, Idaho. Mr Thomas Michael Jackson is licensed to practice in Idaho (license number 021) and his current practice location is 7 Bitterroot Road, Carmen, Idaho. He can be reached at his office (for appointments etc.) via phone at
(208) 756-8047.
NPI number for Mr Thomas Michael Jackson is 1134380694 and his current mailing address is 7 Bitterroot Road, Po Box 47, Carmen, Idaho. He
does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1134380694.
Physician's Profile
| Full Name | Mr Thomas Michael Jackson |
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| Gender | Male |
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| Speciality | Emergency Medicine |
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| Location | 7 Bitterroot Road, Carmen, Idaho |
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| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
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NPI Data:
- NPI Number: 1134380694
- Provider Enumeration Date: 06/18/2008
- Last Update Date: 06/18/2008
Medical Identifiers
Medical identifiers for Mr Thomas Michael Jackson such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1134380694 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 207P00000X | Emergency Medicine | 021 (Idaho) | 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. Mr Thomas Michael Jackson is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Mr Thomas Michael Jackson, DO
7 Bitterroot Road, Po Box 47,
Carmen, ID 83462
Ph: (208) 756-8047 | Mr Thomas Michael Jackson, DO
7 Bitterroot Road,
Carmen, ID 83462
Ph: (208) 756-8047 |
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