Jackson Primary Care Llc | |
2685 E Main St Suite A Ste A Jackson MO 63755 | |
(573) 204-1400 | |
(573) 204-1480 |
Full Name | Jackson Primary Care Llc |
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Speciality | Family Medicine |
Location | 2685 E Main St Suite A, Jackson, Missouri |
Authorized Official Name and Position | Deanna M Siemer (OWNER) |
Authorized Official Contact | 5732041400 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Jackson Primary Care Llc 2685 E Main St Suite A Ste A Jackson MO 63755 Ph: (573) 204-1400 | Jackson Primary Care Llc 2685 E Main St Suite A Ste A Jackson MO 63755 Ph: (573) 204-1400 |
NPI Number | 1619961380 |
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Provider Enumeration Date | 09/08/2005 |
Last Update Date | 10/26/2010 |
Medicare PECOS PAC ID | 3476508581 |
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Medicare Enrollment ID | O20050322000111 |
Identifier | Type | State | Issuer |
---|---|---|---|
1619961380 | NPI | - | NPPES |
132588 | Other | MO | BCBS |
509303004 | Medicaid | MO |
Provider Name | Janae J Eskew |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1942277249 PECOS PAC ID: 3971529611 Enrollment ID: I20051021000187 |
Provider Name | Deanna M Siemer |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1851368153 PECOS PAC ID: 4385772169 Enrollment ID: I20100514000884 |
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