Shawn Barrett Jackson, M,D, | |
1000 E Primrose St Ste 550, Springfield, MO 65807-5180 | |
(417) 269-4646 | |
Not Available |
Full Name | Shawn Barrett Jackson |
---|---|
Gender | Male |
Speciality | Pathology |
Experience | 27 Years |
Location | 1000 E Primrose St Ste 550, Springfield, Missouri |
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 |
---|---|---|---|
1730258708 | NPI | - | NPPES |
700100407 | Medicaid | MO | |
1101160 | Other | MO | UNITED HEALTHCARE |
421539307 | Other | MO | FED TAX ID-TRI-LAKES PATH |
1559 | Other | MO | BLUECROSSBLUESHIELD-PATHO |
431451388 | Other | MO | FED TAX ID-PATHOLOGY SERV |
159012 | Other | MO | BLUECROSSBLUESHIELD-TRI-L |
705866705 | Medicaid | MO |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207ZD0900X | Pathology - Dermatopathology | 2005005716 (Missouri) | Secondary |
207ZP0102X | Pathology - Anatomic Pathology & Clinical Pathology | 2005005716 (Missouri) | Primary |
Facility Name | Location | Facility Type |
---|---|---|
Cox Medical Centers | Springfield, MO | Hospital |
Cox Medical Center Branson | Branson, MO | Hospital |
Group Practice Name | Group PECOS PAC ID | No. of Members |
---|---|---|
Pathology Services Of Springfield Pc | 2062308133 | 9 |
Entity Name | Pathology Services Of Springfield Pc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1801935879 PECOS PAC ID: 2062308133 Enrollment ID: O20040225000699 |
Entity Name | Citizens Memorial Hospital District |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1558548818 PECOS PAC ID: 2769574433 Enrollment ID: O20070827000044 |
Mailing Address | Practice Location Address |
---|---|
Shawn Barrett Jackson, M,D, 1000 E Primrose St Ste 550, Springfield, MO 65807-5180 Ph: (417) 269-4646 | Shawn Barrett Jackson, M,D, 1000 E Primrose St Ste 550, Springfield, MO 65807-5180 Ph: (417) 269-4646 |
James Mason Shelley Jr., M.D. Pathology Medicare: Not Enrolled in Medicare Practice Location: 1000 E Primrose St Ste 550, Springfield, MO 65807 Phone: 417-269-4647 Fax: 417-269-8078 | |
Mary Kay Vaske, MD Pathology Medicare: Not Enrolled in Medicare Practice Location: 1235 E Cherokee St, Pathology, Springfield, MO 65804 Phone: 417-820-6850 Fax: 417-820-7790 | |
Dr. Steven E. Collum, M.D. Pathology Medicare: Accepting Medicare Assignments Practice Location: 1235 E Cherokee St, Springfield, MO 65804 Phone: 417-820-2961 Fax: 417-820-7790 | |
Ms. Cassie Lee Booth, MD Pathology Medicare: Accepting Medicare Assignments Practice Location: 1235 E Cherokee St, Springfield, MO 65804 Phone: 417-820-2961 | |
Geoffrey Glenn Herndon, DO Pathology Medicare: Medicare Enrolled Practice Location: 1000 E Primrose St Ste 550, Springfield, MO 65807 Phone: 417-269-4646 | |
Jon D Lorenzino, MD Pathology Medicare: Accepting Medicare Assignments Practice Location: 607 W Battlefield St, Springfield, MO 65807 Phone: 417-869-2000 Fax: 417-881-1850 | |
Dr. Lacey Marie Winchester, M.D. Pathology Medicare: Accepting Medicare Assignments Practice Location: 1000 E Primrose St Ste 550, Springfield, MO 65807 Phone: 417-269-4646 |