| Randy D Jackson, PA-C | |
|
200 Somerset St, Suite 2, Millinocket, ME 04462-1258 | |
| (207) 723-5173 | |
| (207) 723-3040 |
| Full Name | Randy D Jackson |
|---|---|
| Gender | Male |
| Speciality | Physician Assistant |
| Location | 200 Somerset St, Millinocket, Maine |
| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1508825357 | NPI | - | NPPES |
| 079032 | Other | ME | ANTHEM |
| 201855 | Other | ME | NGS |
| 1508825357 | Medicaid | ME |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363A00000X | Physician Assistant | PA-028 (Maine) | Primary |
| Mailing Address | Practice Location Address |
|---|---|
| Randy D Jackson, PA-C 200 Somerset St, Millinocket, ME 04462-1258 Ph: (207) 723-5173 | Randy D Jackson, PA-C 200 Somerset St, Suite 2, Millinocket, ME 04462-1258 Ph: (207) 723-5173 |
Mr. David P Johnson, PA Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 165 Poplar Street, Suite #1, Millinocket, ME 04462 Phone: 207-723-2034 Fax: 207-723-3006 | |
Mr. Andre Parent, PAC Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 200 Somerset St, Millinocket, ME 04462 Phone: 207-723-5161 Fax: 207-723-3028 | |
Robert Cleaveland, PHYSICIAN ASSISTANT Physician Assistant Medicare: Medicare Enrolled Practice Location: 50 Summer St, Millinocket, ME 04462 Phone: 207-723-6551 Fax: 207-528-2595 | |
Mr. Douglas Rhoda, PAC Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 200 Somerset St, Millinocket, ME 04462 Phone: 207-723-5161 Fax: 207-723-3028 |