| Jackson Primary Care | |
|
2010 Church St Ste 526 Nashville TN 37203 | |
| (615) 329-7969 | |
| Not Available |
| Full Name | Jackson Primary Care |
|---|---|
| Speciality | Family Medicine |
| Location | 2010 Church St Ste 526, Nashville, Tennessee |
| Authorized Official Name and Position | Robert Eric Jackson (CEO) |
| Authorized Official Contact | 6154233276 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Jackson Primary Care 2010 Church St Ste 526 Nashville TN 37203-2026 Ph: (615) 329-7969 | Jackson Primary Care 2010 Church St Ste 526 Nashville TN 37203 Ph: (615) 329-7969 |
| NPI Number | 1235634023 |
|---|---|
| Provider Enumeration Date | 03/26/2018 |
| Last Update Date | 08/01/2018 |
| Medicare PECOS PAC ID | 9638411333 |
|---|---|
| Medicare Enrollment ID | O20190429002878 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1235634023 | NPI | - | NPPES |
| Q020871 | Medicaid | TN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 50448 (Tennessee) | Primary |
| Provider Name | Robert E Jackson |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1144305152 PECOS PAC ID: 9133101744 Enrollment ID: I20130920000128 |
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