William Jackson, MD | |
1441 Ne 10th Ave, Payette, ID 83661-5420 | |
(208) 642-9376 | |
(208) 642-9279 |
Full Name | William Jackson |
---|---|
Gender | Male |
Speciality | Family Medicine |
Location | 1441 Ne 10th Ave, Payette, Idaho |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1740530302 | NPI | - | NPPES |
M-14093 | Other | ID | STATE OF IDAHO MEDICAL LICENSE |
MD187049 | Other | OR | STATE OF OREGON, MEDICAL LICENSE |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | MD187049 (Oregon) | Secondary |
207Q00000X | Family Medicine | M-14093 (Idaho) | Primary |
Entity Name | Ashley Valley Physician Practice Llc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1740482025 PECOS PAC ID: 4284683947 Enrollment ID: O20050119001166 |
Mailing Address | Practice Location Address |
---|---|
William Jackson, MD 1441 Ne 10th Ave, Payette, ID 83661-5420 Ph: (208) 642-9376 | William Jackson, MD 1441 Ne 10th Ave, Payette, ID 83661-5420 Ph: (208) 642-9376 |
Graceful Iris Morris, FNP Family Medicine Medicare: Not Enrolled in Medicare Practice Location: 1000 S 16th St # C, Payette, ID 83661 Phone: 208-642-9222 | |
Shannon D. Schantz, M.D. Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 1441 Ne 10th Ave, Payette, ID 83661 Phone: 208-642-9376 Fax: 208-642-9598 | |
Yvette Rene Sweet, DO Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 1441 Ne 10th Ave, Payette, ID 83661 Phone: 208-642-9376 Fax: 208-642-9598 | |
Dr. Ronald Eugene Carroll, M.D. Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 823 Center Ave, Payette, ID 83661 Phone: 208-642-3396 Fax: 208-642-9060 | |
Joann E Buhr Cote, DNP Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 823 Center Ave, Payette, ID 83661 Phone: 208-642-3396 Fax: 208-642-9060 |